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A 3-year-old child is admitted with a Stage II Wilm's tumor. Which preoperative intervention(s) should the nurse implement? Choose all that apply.

A.

Explain expected side effects of postoperative chemotherapy.

B.

Monitor blood pressure every 2 hours for hypertension.

C.

Provide parents with simple explanations and repeat often.

D.

Attend all healthcare provider and parent conferences.

E.

Measure the child's abdominal girth.

Answer and Explanation

Correct Answer : B,C,E

A. Explain expected side effects of postoperative chemotherapy: Chemotherapy and its side effects are typically discussed after surgery when the treatment plan is clearer. The focus before surgery should be on preparing the child and family for the surgery itself.

B. Monitor blood pressure every 2 hours for hypertension: Wilm's tumor can be associated with hypertension due to renin production from the tumor, so monitoring the child's blood pressure closely is essential to detect any signs of hypertension early.

C. Provide parents with simple explanations and repeat often: Simplified, repeated explanations are key to helping parents understand the diagnosis and surgical procedure. This approach supports emotional comfort and ensures informed decision-making.

D. Attend all healthcare provider and parent conferences: While it is important to support the family, the nurse’s role in attending all healthcare provider and parent conferences is not mandatory unless specifically needed for continuity of care.

E. Measure the child's abdominal girth: Measuring abdominal girth is essential preoperatively to monitor for any abdominal changes, such as swelling or distension, which could indicate tumor growth or other complications related to the Wilm's tumor.


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Related Questions

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B","dropdown-group-3":"B"}

Explanation

Rationale for Correct Choices:

  • Impaired physical mobility: Rheumatoid arthritis leads to joint inflammation, stiffness, and potential deformities. These symptoms may result in decreased range of motion and difficulty with physical movements, contributing to impaired mobility.
  • Acute pain: RA causes acute inflammation in the joints, resulting in pain, especially during flare-ups. The client experiences pain and stiffness in the hands and wrists, which aligns with the acute pain risk associated with RA.
  • Knowledge deficit: Newly diagnosed RA patients often lack understanding about the disease process, treatment options, and lifestyle modifications. The nurse needs to recognize that the client requires education to manage their condition effectively and understand the long-term implications.

Rationale for Incorrect Choices:

  • Electrolyte imbalance: Electrolyte imbalances are not a typical complication of rheumatoid arthritis. While certain medications used to treat RA (like corticosteroids) can impact electrolyte levels, this is not an immediate concern or a direct risk associated with RA itself.

Correct Answer is {"dropdown-group-1":"A"}

Explanation

Rationale for Correct Choice:

  • Depression: The client has symptoms of depression, such as general malaise, fatigue, decreased appetite, withdrawal, flat affect, and poor hygiene. Additionally, the client reports a significant change in sleep patterns, with an inability to sleep at night. His alcohol consumption could also contribute to depressive symptoms.

Rationale for Incorrect Choices:

  • Anxiety disorder: While anxiety can cause fatigue, disrupted sleep, and lack of energy, it typically also presents with heightened nervousness, restlessness, excessive worry, or physical symptoms like rapid heart rate, which are not reported here. The client's withdrawal and lack of energy are more consistent with depression.
  • Hypothyroidism: Hypothyroidism can cause fatigue, weight gain, and poor appetite, but the client's low BMI (17.7 kg/m²) suggests that weight loss, rather than gain, is occurring. Additionally, the lack of other hypothyroid symptoms, like constipation or cold intolerance, makes hypothyroidism less likely than depression in this scenario.

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