A child is admitted with a suspected diagnosis of Wilms tumor. The nurse should place a sign with which of the following warnings over the child’s bed?
A.
Do not palpate abdomen
B.
Contact precautions
C.
Collect all urine
D.
No venipuncture or blood pressure in left arm
The Correct Answer and Explanation is:
The correct answer is A. Do not palpate abdomen.
Explanation:
Wilms tumor, or nephroblastoma, is a common kidney cancer found in children. It typically presents as a palpable abdominal mass, and one of the critical nursing considerations is to prevent any manipulation of the tumor. Palpating the abdomen can potentially rupture the tumor, leading to several complications, including hemorrhage, spread of cancer cells, and peritonitis. Therefore, it is essential for healthcare providers to ensure that the child’s abdomen is not palpated, which is why a sign with the warning “Do not palpate abdomen” is placed over the child’s bed.
In addition to preventing palpation, several other nursing interventions are critical for a child with Wilms tumor. For instance, the nurse must monitor for any signs of complications, including hypertension and abdominal pain, which may arise from the tumor’s presence or associated treatments. Furthermore, if the child requires any diagnostic imaging or surgical interventions, those should be planned with care to minimize the risk of tumor manipulation.
While other options may also be relevant in certain contexts, they do not apply specifically to the management of a Wilms tumor. For example, B. Contact precautions might be necessary if there is a risk of infection but are not specifically related to the tumor itself. C. Collect all urine is more relevant in monitoring kidney function and could be important in other scenarios, but it doesn’t directly address the immediate risk associated with the Wilms tumor. Lastly, D. No venipuncture or blood pressure in the left arm is generally relevant in cases where there is a specific risk in that limb, but without further context, it is not a standard precaution for Wilms tumor management.
In summary, the priority for nursing care in a child with a suspected Wilms tumor is to prevent any abdominal palpation to avoid serious complications, making option A the most appropriate warning to place over the child’s bed.