A charge nurse is assisting a newly licensed nurse with the preoperative assessment of a 2-year-old child who has a Wilms' tumor. Which of the following actions by the newly licensed nurse indicates an understanding of the needed care?

A. Decreased respiratory rate: AKI typically does not directly affect respiratory rate. Respiratory rate is more closely related to lung function and oxygenation status rather than kidney function.

B. Polyuria: This is an incorrect option. Polyuria, or increased urine output, is not typically seen in acute kidney injury. In fact, oliguria (decreased urine output) or anuria (absence of urine output) are more common in AKI due to decreased kidney function.

C. Hyperactivity: AKI does not typically cause hyperactivity. In fact, children with AKI may appear lethargic or fatigued due to the buildup of waste products in their bodies and electrolyte imbalances.

D. Edema: This is the correct option. Edema, or swelling due to fluid retention, is a common clinical manifestation of AKI. When the kidneys are unable to adequately filter and excrete excess fluid from the body, fluid accumulates in the tissues, leading to edema. Edema may be particularly noticeable in the face, hands, feet, or around the eyes.

A. Preschoolers believe their illness is punishment for their misbehavior:This statement is true. Preschool-aged children often have a limited understanding of illness and may associate it with punishment. They might think that their illness is a consequence of something they did wrong. As a nurse, it’s essential to address these misconceptions and provide age-appropriate explanations to help them understand their condition better.

B. Preschoolers are interested in what happens to the body after death: Preschoolers may have curiosity about death and what happens afterward, but their understanding is typically limited. They may ask simple questions about death and may need age-appropriate explanations about the concept. Providing information in a sensitive and honest manner can help address their curiosity and alleviate fears.

C. Adolescents worry more about death than the physical changes that can occur as a result of the illness: Adolescents facing terminal illness may have complex emotions and concerns about both death and the physical changes associated with their illness. It's important to acknowledge and address both aspects of their experience, providing opportunities for adolescents to express their feelings and concerns in a supportive environment.

D. Toddlers personify death as being a type of monster: Toddlers often have limited understanding of death and may personify it in different ways, including as a monster or some other abstract concept. It's essential for guardians to provide comfort and reassurance to toddlers who may experience fear or confusion about death. Providing simple and concrete explanations about death, tailored to their developmental level, can help alleviate anxiety.