A nurse is providing discharge teaching to the caregiver of a 3-year-old preschooler client who is 2 days postoperative for Wilms tumor on the pediatric unit. Which of the following statements by the child's caregiver indicates an understanding of the discharge teaching? Select the 3 statements that indicate the teaching was effective.

Brief Introduction Discharge planning for a child following a nephrectomy for Wilms tumor focuses on monitoring for complications and understanding the multi-modal treatment plan. Knowledge of post-operative risks, infection signs, and the role of adjuvant therapies is essential to ensure the caregiver can provide safe home care. Choice A rationale: Most children with a unilateral Wilms tumor do not require a kidney transplant. The remaining healthy kidney typically undergoes compensatory hypertrophy to maintain adequate renal function for the body, provided it is protected from injury or nephrotoxic substances. Choice B rationale: Monitoring bowel movements is crucial because post-operative adhesions or vincristine-induced side effects can lead to constipation or paralytic ileus. Caregivers must ensure the child maintains normal bowel habits to prevent abdominal complications during the recovery and chemotherapy phases. Choice C rationale: A fever can be an early sign of post-operative infection or neutropenia resulting from chemotherapy. Because the child is immunocompromised during cancer treatment, prompt reporting of any temperature elevation is vital to prevent life-threatening sepsis or systemic infection. Choice D rationale: Wilms tumor management almost always includes chemotherapy following surgical resection to target any remaining microscopic cancer cells and prevent recurrence. This systemic treatment is a standard component of the pediatric oncology protocol for this specific renal malignancy. Choice E rationale: Dialysis is only necessary if both kidneys are removed or if the remaining kidney fails. Since a unilateral Wilms tumor leaves one functional kidney, the child should not require weekly dialysis treatments to filter waste from the blood.