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?

Do not palpate abdomen

Contact precautions

Collect all urine

No venipuncture or blood pressure in left arm

Answer and Explanation

The Correct Answer is A

A. Do not palpate abdomen: Wilms tumor, also known as nephroblastoma, is a type of kidney cancer that primarily affects children. Palpation of the abdomen in a child with Wilms tumor can potentially rupture the tumor capsule and lead to dissemination of cancer cells or cause bleeding. Therefore, it is essential to instruct healthcare providers and caregivers not to palpate the child's abdomen to avoid complications.
B. Contact precautions: Contact precautions are not typically indicated for Wilms tumor. Contact precautions are implemented to prevent the transmission of infectious agents that are spread by direct or indirect contact with the client or their environment. Wilms tumor is not contagious and does not require contact precautions.
C. Collect all urine: While collecting urine may be necessary for diagnostic purposes and monitoring kidney function in a child with Wilms tumor, it is not the primary warning associated with the condition. The priority warning for Wilms tumor focuses on avoiding palpation of the abdomen to prevent potential complications.
D. No venipuncture or blood pressure in left arm: While venipuncture or blood pressure measurement in the left arm may be contraindicated in some situations, such as when a client has a central venous catheter or arteriovenous fistula, it is not specifically associated with Wilms tumor. The primary concern with Wilms tumor is to avoid palpation of the abdomen due to the risk of tumor rupture and dissemination of cancer cells.

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Correct Answer is D

Explanation

A. Instruct the client to sit down and stop pacing: Instructing the client to sit down and stop pacing may escalate the client's anxiety and agitation. It's important to provide support and assistance rather than giving orders that could exacerbate the situation.
B. Have a staff member escort the client to her room: Forcing the client to go to her room may increase feelings of being trapped or controlled, potentially worsening the anxiety. It's important to respect the client's autonomy and provide support in a less restrictive manner.
C. Allow the client to pace alone until physically tired: While it's important to allow clients some degree of autonomy, pacing alone may not effectively address the client's escalating anxiety. The nurse should remain engaged and offer support during this time.
D. Walk with the client at a gradually slower pace: This is the most appropriate action. Walking alongside the client allows the nurse to provide support, demonstrate empathy, and potentially de-escalate the situation. Gradually slowing the pace can help the client regulate their own emotions and decrease anxiety. It also provides an opportunity for therapeutic communication and assessment of the client's needs.

A. The client runs 4 miles outdoors every afternoon B. The client eats 2 to 3 g of sodium containing foods C. The client eats foods high in tyramine D. The client drinks 2 litres of liquids daily

Correct Answer is A

Explanation

A. The client runs 4 miles outdoors every afternoon: Exercise, especially in hot weather, can lead to dehydration and increased sweating, which can result in decreased lithium excretion and increased lithium levels in the blood, leading to toxicity. Therefore, this factor puts the client at risk for lithium toxicity.
B. The client eats 2 to 3 g of sodium-containing foods: Sodium intake can affect lithium levels, as high sodium levels can increase lithium excretion and lower lithium levels. Therefore, eating sodium-containing foods is less likely to contribute to lithium toxicity.
C. The client eats foods high in tyramine: Tyramine-rich foods can interact with certain medications, such as MAOIs, but they do not directly increase the risk of lithium toxicity.
D. The client drinks 2 liters of liquids daily: Adequate hydration is important for clients taking lithium, as dehydration can increase lithium levels. Therefore, drinking 2 liters of liquids daily is not a risk factor for lithium toxicity.

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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?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Explanation

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