An infant who has a Wilms’ tumor is admitted for surgery. Which intervention should the nurse implement during the preoperative period?
A.
Administer pain medication based on the FACES pain scale.
B.
Include the prone position in the every 2 hour turning schedule,
C.
Careful bathing and handling that avoids abdominal manipulation.
D.
Give antiemetic medications to prevent nausea and vomiting.
The Correct Answer and Explanation is :
The correct answer is C. Careful bathing and handling that avoids abdominal manipulation.
Explanation:
Wilms’ tumor, also known as nephroblastoma, is a common type of kidney cancer in children, typically diagnosed in infants and young children. When preparing an infant for surgery to remove the tumor, several key considerations must be addressed to ensure the safety and effectiveness of the procedure.
Rationale for Choice C:
- Abdominal Handling: The Wilms’ tumor is often a large mass in the abdomen, and any manipulation or pressure on the abdomen can lead to tumor rupture or spread of cancer cells. Thus, it is crucial to handle the infant gently, avoiding any unnecessary abdominal pressure. This precaution is essential to prevent any complications that could arise from physical trauma to the tumor site.
- Preoperative Care: During the preoperative period, careful bathing and handling are part of the pre-surgical protocols for infants with Wilms’ tumor. Nurses and healthcare providers should ensure that all procedures and interactions with the infant minimize abdominal pressure. This involves techniques such as avoiding any direct palpation or manipulation of the abdomen and using supportive measures to keep the infant comfortable.
Why Other Options Are Less Appropriate:
- Option A (Administer pain medication based on the FACES pain scale): While pain management is crucial, the FACES pain scale is typically used for older children who can communicate their pain levels. For an infant, pain assessment is generally based on behavioral indicators rather than self-reporting tools.
- Option B (Include the prone position in the every 2-hour turning schedule): The prone position is not appropriate for infants with abdominal tumors as it can increase abdominal pressure. Instead, the infant should be turned and positioned carefully to avoid discomfort and potential trauma to the tumor site.
- Option D (Give antiemetic medications to prevent nausea and vomiting): Anti-nausea medications are more relevant for postoperative care rather than preoperative preparation. Preoperative measures should focus on preparing the child for surgery while minimizing the risk of complications.
In summary, careful bathing and handling that avoids abdominal manipulation is the most critical intervention during the preoperative period for an infant with Wilms’ tumor to ensure safety and prevent complications related to the tumor.