A nurse is admitting a child with a suspected diagnosis of Wilm's tumor. The nurse should place a sign with which of the following warnings about this child?

No venipuncture or blood pressure in either arm.

Avoid administering nephrotoxic medications.

Collect all urine.

Strict fluid restrictions.

Answer and Explanation

The Correct Answer is A

A.   Wilms' tumor is a kidney tumor, and the child should not have blood pressure measured or venipuncture done on the affected side to avoid any potential injury to the kidney.
B.   This is important in care but is not the primary immediate precaution. The main focus is to avoid injury to the affected kidney.
C.   While urine collection is important for monitoring kidney function, it is not a warning sign for Wilms' tumor.
D.   This may be necessary later in the treatment but is not a primary concern for the initial care of a child with Wilms' tumor.

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Correct Answer is []

Explanation

Absence Seizures:

The infant’s clinical presentation, including shaking of the arms and legs, lack of response to touch or voice, and the brief episodes of unconsciousness (lasting around 5 minutes), is consistent with absence seizures (also known as petit mal seizures). These seizures typically involve brief episodes of altered consciousness with subtle motor activity like shaking or jerking, and the child resumes normal activity afterward. The child’s seizure episodes seem to stop on their own, and the child appears to sleep soundly after the episodes, which further points to absence seizures.

Actions to Take:

Initiate seizure precautions:

Seizure precautions are essential to ensure the infant’s safety during and after a seizure episode. This includes making sure the environment is free from hazards and that the infant is being closely monitored.

Keep infant NPO until they are fully awake and alert:

Keeping the infant NPO (nothing by mouth) is essential to prevent aspiration risk during and after the seizure. Once the infant is fully awake and alert, they can resume normal feeding.

Parameters to Monitor:

Level of consciousness:

Monitoring the infant’s level of consciousness is crucial because the primary concern during absence seizures is the alteration of consciousness. After the seizure, assessing their responsiveness and mental state will help evaluate the resolution of the episode.

Motor ability:

The motor ability should be monitored to check for any residual effects from the seizure, such as weakness or abnormal movements, and to assess for any motor symptoms during the seizure.

Explanation of Incorrect Choices:

Akinetic seizures:

Akinetic seizures involve loss of muscle tone and are often associated with sudden collapse or "drop attacks." This is not consistent with the infant’s symptoms, which include shaking rather than sudden loss of muscle tone.

Tonic-clonic seizures:

Tonic-clonic seizures (grand mal seizures) typically involve both tonic (muscle stiffening) and clonic (jerking) movements with a loss of consciousness. While the infant is having shaking episodes, the description does not indicate the full tonic-clonic presentation.

Focal seizures with impaired awareness:

Focal seizures typically involve abnormal activity in one part of the brain and often manifest with

symptoms localized to one area of the body. This infant’s symptoms are more generalized, with shaking

in the arms and legs, and a lack of response, which aligns better with absence seizures.

A. A child with a fever due to a viral infection. B. A child recovering from surgery for a broken arm. C. A child with chicken pox. D. A child with history of asthma.

Correct Answer is D

Explanation

A. A child with a fever due to a viral infection may pose an infection risk to the immunocompromised leukemia patient.
B. A child recovering from surgery may have a wound or infection risk, which could also be a concern for a child receiving chemotherapy.
C. A child with chickenpox is highly contagious and should not be in the same room as an immunocompromised child.
D. A child with asthma is not immunocompromised and is less likely to pose an infection risk to a child undergoing chemotherapy.

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A nurse is admitting a child with a suspected diagnosis of Wilm's tumor. The nurse should place a sign with which of the following warnings about this child?

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Correct Answer is []

Explanation

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Correct Answer is D

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