An infant who has a Wilms' tumor is admitted for surgery. Which intervention should the nurse implement during the preoperative period?

Administer pain medication based on the FACES pain scale.

Include the prone position in the every 2 hour turning schedule,

Careful bathing and handling that avoids abdominal manipulation.

Give antiemetic medications to prevent nausea and vomiting.

Answer and Explanation

The Correct Answer is C

A. Administering pain medication based on the FACES pain scale is not the most relevant intervention in the preoperative period for a Wilms' tumor. Pain management may be addressed postoperatively, as needed.

B. Including the prone position in the every 2-hour turning schedule may not be the most appropriate intervention, as it may not be suitable for an infant with a Wilms' tumor, considering the location and potential size of the tumor.

C. Careful bathing and handling that avoids abdominal manipulation.

Wilms' tumor, also known as nephroblastoma, is a pediatric kidney cancer. Prior to surgery, it's crucial to handle the infant with care and avoid any abdominal manipulation to prevent any further complications or disruption to the tumor. This involves gentle handling and avoiding activities that may put pressure on the tumor or cause discomfort to the infant.

D. Giving antiemetic medications to prevent nausea and vomiting is a potential intervention, but it may be more relevant in the postoperative period, and its necessity would depend on the infant's individual condition and the surgical plan.

The priority during the preoperative period for an infant with a Wilms' tumor is to handle the infant carefully and avoid any actions that could exacerbate the condition or cause discomfort. The specific surgical plan and other preoperative preparations would be determined by the healthcare provider.

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Correct Answer is C

Explanation

A. Disposing of the child's brushes, combs, and other hair accessories can be a good practice to prevent reinfestation, but it is not the primary instruction to provide in this case.

B. Taking the child to a hair salon for a shampoo and a shorter haircut is not a necessary or recommended treatment for head lice.

C. Wash the child's bed linens and clothing in hot soapy water.

When a child has head lice, it's important to take measures to prevent the spread of lice to others and to eliminate any potential sources of reinfestation. Washing the child's bed linens and clothing in hot, soapy water is an essential step in this process to kill any lice or nits (lice eggs) that may be present on these items.

D. Rewashing the child's hair following a 24-hour isolation period is not the standard approach for treating head lice with permethrin shampoo. It is important to follow the specific instructions provided with the product and to avoid overuse or misuse of the treatment.

The primary focus should be on treating the child's hair with the appropriate lice treatment (permethrin shampoo) as directed and taking preventive measures such as washing bed linens and clothing to reduce the risk of reinfestation.

A. Report the assessment to the healthcare provider. B. Determine when oral fluids were last taken. C. Attempt to reduce the hernia manually. D. Prepare to initiate venous access for an intravenous (IV) infusion

Correct Answer is A

Explanation

A. Report the assessment to the healthcare provider.

The changing color of the inguinal hernia to dark purple is concerning and may indicate a possible strangulated hernia, which is a surgical emergency. Additionally, the absence of a bowel movement for 24 hours raises concerns about possible bowel obstruction or compromise. The FLACC score of 8 on the initial assessment suggests that the infant is experiencing significant discomfort or pain.

Therefore, the priority is to report the assessment findings to the healthcare provider to ensure timely evaluation and intervention. The healthcare provider needs to assess the hernia, determine if it is strangulated, and decide on the appropriate course of action, which may include surgery. It is essential to act promptly in this situation to prevent potential complications.

B. Determining when oral fluids were last taken is relevant but should not take precedence over the potential surgical emergency of a strangulated hernia.

C. Attempting to reduce the hernia manually is not advisable in this situation, as it may worsen the condition if the hernia is strangulated.

D. Preparing to initiate venous access for an intravenous (IV) infusion is a consideration but should follow the assessment and reporting of the potential surgical emergency. Intravenous access may be needed as part of the overall management, but the priority is to ensure the infant receives appropriate surgical evaluation and intervention.

A. Report the assessment to the healthcare provider.

B. Determining when oral fluids were last taken is relevant but should not take precedence over the potential surgical emergency of a strangulated hernia.

C. Attempting to reduce the hernia manually is not advisable in this situation, as it may worsen the condition if the hernia is strangulated.

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An infant who has a Wilms' tumor is admitted for surgery. Which intervention should the nurse implement during the preoperative period?

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Correct Answer is C

Explanation

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