A nurse is collecting data from a client who has hypokalemia and recently started potassium chloride supplements. Which of the following findings indicates a positive response to the intervention?

A. "You should give your child captopril 200 mg PO daily.": Captopril is an antihypertensive and is not routinely prescribed for Wilms’ tumor unless the child has hypertension. It is not part of standard preoperative management and should not be included in general parent teaching for tumor care.

B. "Your child should have surgery in 7 to 10 days to remove the tumor.": The timing of surgery is individualized based on the child’s condition, staging, and preoperative assessments. Providing a specific timeframe may be inaccurate and cause unnecessary confusion or anxiety.

C. "Your child will not require further treatment after removal of the tumor.": Wilms’ tumor often requires multimodal therapy, including chemotherapy and sometimes radiation, depending on tumor stage and histology. Parents should be aware that surgery alone may not be sufficient for complete treatment.

D. "You should not palpate your child's abdomen prior to surgery.": Palpating the abdomen can risk rupturing the tumor and spreading cancer cells, which could worsen prognosis. Parents should be instructed to avoid abdominal palpation and handle the child gently until surgical removal of the tumor.

A. Monitor blood pressure: The client’s blood pressure readings (148/94 mm Hg and 156/96 mm Hg) indicate hypertension in pregnancy, which requires frequent monitoring to detect worsening preeclampsia and prevent complications such as stroke or placental abruption.

B. Check urinary output: Elevated BUN and creatinine, along with proteinuria, indicate possible renal involvement from preeclampsia. Monitoring urinary output helps assess kidney function and detect oliguria, a critical warning sign.

C. Initiate contact precautions: There is no evidence of an infectious condition requiring contact precautions. Standard precautions are sufficient for this client.

D. Monitor deep tendon reflexes: Hyperreflexia (DTR 3+) is a hallmark sign of preeclampsia and indicates increased seizure risk. Ongoing monitoring is essential for early recognition of worsening neurological status.

E. Assist with preparing the client for amniocentesis: Amniocentesis is not indicated based on the current clinical findings. Immediate priorities involve maternal stabilization and fetal monitoring, not diagnostic invasive procedures.

F. Encourage bedrest: Bedrest can help reduce blood pressure and improve uteroplacental perfusion in clients with preeclampsia. Positioning the client on her left side optimizes blood flow to the fetus and kidneys.

G. Assist with application of internal fetal monitor: The client has minimal variability on the external fetal monitor, suggesting potential fetal compromise. Internal fetal monitoring may be indicated for more accurate assessment of fetal status, so assisting with its application is appropriate.