Ati paediatrics nursing assessment proctored exam
A charge nurse is assisting a newly licensed nurse with the preoperative care of a 2-year-old toddler who has a Wilms tumor. Which of the following actions by the newly licensed nurse indicates an understanding of the needed care?
Explanation & Rationale
A. Asking the toddler's parents to go to the waiting room: Parents should stay with the child to reduce anxiety and support cooperation. B. Palpating the child's abdomen: Abdominal palpation is contraindicated in Wilms tumor because it can cause tumor rupture and spread cancer cells. C. Discontinuing clear liquids 1 hr prior to surgery: Clear liquids are usually stopped at least 2-6 hours before surgery depending on hospital protocols-not just 1 hour prior. D. Monitoring the child's blood pressure continuously Wilms tumor often affects kidney function, and blood pressure monitoring is crucial because of the risk of hypertension due to renal involvement.
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