A nurse is caring for a toddler whose parent states while bathing the child she noticed a mass in his abdominal area and that his urine is a pink color. Which of the following actions is the nurse's priority?
Determine if the child is having pain.
Obtain a urine specimen for a urinalysis.
Instruct the parent to avoid pressing on the abdominal area.
Schedule the child for an abdominal ultrasound.
The Correct Answer is C
A. While assessing for pain is important, it is not the priority in this situation. The presence of pink- colored urine and a palpable mass in the abdominal area are more concerning findings that warrant immediate investigation.
B. Obtaining a urine specimen for analysis is important for diagnosing the cause of the hematuria (blood in the urine), which is a common symptom of Wilms tumor. However, this is not the immediate priority compared to preventing potential harm to the child by avoiding pressure on the abdominal area.
C. Instructing the parent to avoid pressing on the abdominal area is the priority action. Wilms tumor can rupture with pressure, which can lead to the spread of cancer cells. It is crucial to minimize handling of the tumor to prevent tumor spillage into the abdominal cavity.
D. The decision to schedule additional diagnostic tests, such as an abdominal ultrasound, can be made based on the results of the urinalysis and further clinical assessment.
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Related Questions
Correct Answer is D
Explanation
A. Neuroblastoma is a type of cancer that arises from immature nerve cells and commonly affects infants and young children. While it can occur in the abdomen, it is not primarily a renal tumor.
B. Ewing sarcoma is a type of bone cancer that primarily affects children and adolescents. It typically arises in the bones of the pelvis, legs, arms, ribs, or spine. While it can involve the abdominal area if it metastasizes (spreads), it is not primarily an intra-abdominal tumor.
C. Osteosarcoma commonly arises in the long bones of the arms and legs. While it can spread to other parts of the body, including the abdomen, it is primarily a bone tumor.
D. Wilms' tumor, also known as nephroblastoma, is the most common malignant renal (kidney) tumor of childhood. It typically occurs in children around 2 to 5 years old and is often detected as a firm, non- tender abdominal mass.
Correct Answer is A
Explanation
Notifying the provider allows for assessment of the situation, possibly perform a medical evaluation to determine if the bruises are of medical concern, and decide on further actions.
B. Ask the toddler what caused the bruises is not always reliable to provide information of sensitive issues. However, asking them can sometimes provide useful information.
C. Ask the parents what caused the bruises may mislead the team as the parents may lie about the bruises if they are perpetrators of child abuse.
D. Notification of social service is important in suspected cases of neglect or abuse. However, this should follow assessment by the provider
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