A nurse is instructing a client who has a new diagnosis of Raynaud's disease about preventing the onset of manifestations. Which of the following client statements should indicate to the nurse the need for additional teaching?

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.

Sharing personal passwords for accessing electronic client records is a violation of healthcare privacy and security regulations, such as the Health Insurance Portability and Accountability Act (HIPAA). Personal passwords should never be shared with anyone, regardless of their role or position within the healthcare facility. Each individual accessing electronic records should have their own unique login credentials to maintain accountability and protect the confidentiality of client information.
A. The nurse manager: While the nurse manager may have legitimate reasons to access client records, they should do so using their own authorized credentials. Sharing passwords compromises security and accountability.
B. A nursing student who is completing a preceptorship on the unit: Nursing students should be provided with their own temporary login credentials or supervised access to client records as part of their educational experience. Sharing personal passwords with students is inappropriate and violates privacy regulations.
C. The unit clerk: Unit clerks may require access to certain client information for administrative purposes, but they should have their own authorized login credentials provided by the facility. Sharing passwords with non-clinical staff like unit clerks poses risks to client privacy and confidentiality.
D. No one: This option is the correct choice. Personal passwords should never be shared with anyone, as doing so compromises security, violates privacy regulations, and undermines accountability for accessing electronic client records.