The parents of a child who is diagnosed with Wilm’s tumor ask the nurse why surgery is necessary before a biopsy is performed.

What information should the nurse provide?

Choice A rationale
Enalapril is an angiotensin-converting enzyme (ACE) inhibitor commonly used in the treatment of heart failure. It works by widening blood vessels, which reduces the workload of the heart and helps keep heart failure from getting worse. In the given scenario, there is no specific indication to hold Enalapril based on the infant’s vital signs.
Choice B rationale
Digoxin is a medication that can help the heart beat stronger with a more regular rhythm. However, it is important to monitor the patient’s heart rate when administering Digoxin, as it can lower the heart rate. In this case, the infant’s apical pulse is 88 beats/minute, which is lower than the normal range for an eight-month-old infant (normal range: 100-160 beats/minute). Therefore, the nurse should hold the Digoxin and inform the healthcare provider.
Choice C rationale
Furosemide is a diuretic that helps the kidneys get rid of extra fluid that may build up in the body. It is often used in the treatment of heart failure to relieve symptoms such as fluid retention. In the given scenario, there is no specific indication to hold Furosemide based on the infant’s vital signs.
Choice D rationale
Hydralazine is a medication used to treat high blood pressure. It works by relaxing and widening blood vessels so blood can flow more easily. In the given scenario, there is no specific indication to hold Hydralazine based on the infant’s vital signs.

Choice A rationale
The initial phase of treatment for a school-age child with left femoral osteomyelitis involves ensuring no weight-bearing on the affected extremity. This is crucial because weight bearing can exacerbate the condition and cause further damage to the bone. The child should be encouraged to rest and avoid activities that put pressure on the affected limb. This measure, combined with appropriate antibiotic therapy, helps to control the infection and prevent complications.
Choice B rationale
Administering topical antibiotic therapy daily is not typically the primary mode of treatment for osteomyelitis. Osteomyelitis is a deep bone infection, and topical antibiotics may not reach the site of infection effectively. Instead, systemic antibiotics are usually administered intravenously, especially in the initial phase of treatment.
Choice C rationale
Scheduling ice pack applications to the infected area is not a standard treatment for osteomyelitis. While ice packs can help reduce inflammation and pain in some conditions, they are not typically used in the management of osteomyelitis. The primary treatment for osteomyelitis is antibiotic therapy.
Choice D rationale
Providing a passive range of motion exercises is not typically part of the initial phase of treatment for osteomyelitis. While physical therapy and exercises can be beneficial in the recovery phase to restore function and mobility, they are not usually recommended in the initial phase when the infection is active and the bone is inflamed.