A nurse is caring for a pediatric client who is suspected to have Wilms tumor.
Which of the following diagnostic procedures is key in confirming the diagnosis of Wilms tumor?

Choice A rationale

Administering medication without a competent client's knowledge or consent constitutes battery, an intentional tort. Battery involves an unconsented touching of another person, even if the intent is benevolent. This action violates the client's autonomy and right to self-determination regarding their medical treatment, which is a fundamental ethical and legal principle in healthcare.

Choice B rationale

Applying restraints to a competent, alert, and oriented client who wishes to leave against medical advice is false imprisonment, an intentional tort. False imprisonment involves the unlawful restraint of a person against their will. Competent adults have the right to refuse treatment and discharge themselves, and their freedom of movement cannot be unduly restricted.

Choice C rationale

Threatening to apply restraints to a client for not adhering to a dietary restriction constitutes assault, an intentional tort. Assault involves placing another person in reasonable apprehension of an immediate harmful or offensive contact. While dietary adherence is important, threatening physical restraint for non-compliance is an inappropriate and unlawful response.

Choice D rationale

This scenario exemplifies negligence, which is unintentional tort. Negligence occurs when a healthcare professional fails to act as a reasonably prudent nurse would under similar circumstances, resulting in harm to the patient. The delay in reporting a critical change in a client's condition, such as absent peripheral pulsation, falls below the standard of care and can lead to severe and irreversible tissue damage or limb loss.

Choice A rationale

Hypertension is less likely to be a direct complication of peritoneal dialysis. In fact, effective peritoneal dialysis can help manage fluid balance and remove excess sodium, which can contribute to better blood pressure control in individuals with kidney failure. The process aims to remove solutes and water, often mitigating hypertensive states.

Choice B rationale

Hyperglycemia can be a complication of peritoneal dialysis due to the high dextrose concentration in the dialysate solution. Dextrose, a type of sugar, is used as an osmotic agent to draw excess fluid and waste products from the blood into the peritoneal cavity. This can lead to increased glucose absorption into the bloodstream.

Choice C rationale

Peritonitis, an inflammation of the peritoneum, is the most common and serious complication of peritoneal dialysis. It occurs due to bacterial or fungal contamination of the peritoneal cavity, often introduced during catheter manipulation or connection. Symptoms include abdominal pain, cloudy dialysate, and fever, requiring prompt antibiotic treatment.

Choice D rationale

Hypokalemia is generally not a common complication of peritoneal dialysis. The dialysate solution typically contains potassium or is potassium-free, allowing for controlled removal of potassium from the body. However, significant potassium imbalances are usually managed by adjusting the dialysate composition rather than being a frequent, inherent complication.