Which physical assessment technique will the nurse omit when caring for a 2-year-old child diagnosed with Wilms' tumor?

Percussing ankle and knee reflexes

Assessing for bowel sounds

Performing range-of-motion exercises on low extremities

Palpating the abdomen

Answer and Explanation

The Correct Answer is D

A. Percussing ankle and knee reflexes. Safe and non-invasive, and does not risk disturbing the tumor.
B. Assessing for bowel sounds. Routine part of assessment and does not involve manipulating the tumor.
C. Performing range-of-motion exercises on lower extremities. Safe and non-invasive, unrelated to the abdominal tumor.
D. Palpating the abdomen. Palpating the abdomen in a child with Wilms' tumor is avoided to prevent the risk of tumor rupture and subsequent metastasis.

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Correct Answer is C

Explanation

A. Test the urine for ketones. While testing for ketones can be part of illness management in diabetes, it is not as immediate an action as contacting a healthcare provider when blood glucose levels are very high.
B. Withhold insulin dose if feeling nauseous. Insulin should not be withheld due to nausea. It is important to maintain insulin to control blood glucose levels even when feeling unwell. Adjustments to insulin may be necessary based on blood glucose levels and food intake.
C. Notify the provider if blood glucose levels are over 350 mg/dL. Blood glucose levels over 350 mg/dL are concerning and may indicate the need for medical intervention to prevent complications like diabetic ketoacidosis. The healthcare provider should be notified.
D. Limit fluid intake during meal time. Adequate fluid intake is important, especially when blood glucose levels are high, to help prevent dehydration and facilitate glucose clearance. Limiting fluids is not appropriate.

A. Change diapers frequently B. Allow the buttocks to air-dry C. Use commercial baby wipes that are free of alcohol and fragrances to cleanse the area D. Apply zinc oxide ointment to the affected area E. Apply talcum powder with every diaper change

Correct Answer is ["A","B","C","D"]

Explanation

A. Change diapers frequently. Frequent diaper changes reduce prolonged contact with moisture, decreasing the risk of dermatitis.
B. Allow the buttocks to air-dry. Air-drying helps to keep the skin dry and allows it to heal, preventing further irritation.
C. Use commercial baby wipes that are free of alcohol and fragrances to cleanse the area. Alcohol and fragrance-free wipes minimize further irritation to the sensitive skin.
D. Apply zinc oxide ointment to the affected area. Zinc oxide creates a protective barrier that helps heal and protect the skin from moisture and irritants.
E. Apply talcum powder with every diaper change. Talcum powder is not recommended as it can be inhaled by the infant and may cause respiratory issues.

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Which physical assessment technique will the nurse omit when caring for a 2-year-old child diagnosed with Wilms' tumor?

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