Unit 7: NR328 - Nursing care: Altered cellular regulation in pediatrics

For each finding, indicate if the finding is consistent with clinical manifestations of acute lymphoblastic leukemia, Wilms tumor, or both.​

Acute lymphoblastic leukemia - Most often in children under the age of 5​ Pain Weight loss​ Wilms tumor - ALL

The nurse is caring for a 5-year-old who will be undergoing surgery for removal of a neuroblastoma on the adrenal gland. Which are appropriate ways to help the child cope with their fear of the procedure? Select all that apply.​

ALL

For each nursing action, indicate whether it supports the nursing diagnosis of acute pain, disturbed body image, or impaired physical mobility. ​

Acute pain - Acknowledge and normalize the phantom pain​, Collaborate with client about possible methods to reduce pain​ Disturbed body image - Assess the meaning of the loss of the limb to the client​ Assist client to accept support and visits from peers​ Encourage expression of feelings of loss of limb​ Impaired physical mobility - Collaborate to develop goals for independent transfer from bed to chair​, Offer choices in progressing ambulation with various adaptive equipment​

For each assessment finding, indicate whether it supports the nursing diagnosis of acute pain, disturbed body image, or impaired physical mobility. Each assessment finding may support more than one nursing diagnosis.​

Acute pain - below the knee amputation, pain rating Disturbed body image - all except pain rating Impaired physical mobility - Below the knee amputation​ Declining fitting for prosthesis​

The nurse is caring for a 4-year-old who is receiving chemotherapy and is experiencing nausea and vomiting. Which is the best nursing action to address the problem?​

Allow the child to choose what to eat for meals​

The nurse has been asked to prepare the child for immediate surgery. Which actions should the nurse take? Select all that apply.​

Consult a child life specialist​ Prepare surgical consent​ Call report to the preoperative nurse​ Educate caregiver about what to expect​

The nurse is caring for a child with a Wilms tumor. Which assessment findings does the nurse anticipate? Select all that apply.​

Hypertension Hematuria Abdominal mass​

The nurse is caring for a pediatric client who is undergoing chemotherapy treatment for acute lymphoblastic leukemia (ALL). The planned treatment is intermittent and may last up to two years. Which intravenous line should the nurse advocate for the client?​

Implanted port

For each assessment finding, select whether the finding indicates that the client's condition is improved, unchanged, or declined. ​

Improved - abdomen Bp urine Unchanged - weight declined - bowel movement

The nurse is caring for a toddler who is recovering from surgery to remove a cancerous tumor. Which assessment finding best indicates the child's pain is decreasing?​

Increased interest in play​

For each potential nursing intervention, indicate if the intervention is indicated or contraindicated. ​

Indicated - Educate child and caregiver about the ordered diagnostic tests​, Monitor blood pressure​, Request an order for a urinalysis​ Contraindicated - Advise that surgical removal will take place in 1 to 2 months​, Palpate the abdominal mass​

The nurse is caring for a client being treated for acute lymphocytic leukemia (ALL). The client's white blood cell count is 7,000 cells/mm³. A priority nursing diagnosis for this client is risk for infection. Which outcome best indicates the client remains infection-free?​

Temperature remains within normal range​

The client is most at risk for --- as evidenced by the client's abdominal mass and ---

Wilms tumor, hematuria

The nurse is caring for a client receiving chemotherapy who is experiencing nausea and vomiting. The highest priority nursing diagnosis for the nurse to address is --- The action the nurse should take is to administer the client's prescribed ---

fluid and electrolyte imbalance, ondansetron

Highlight the assessment findings in the EHR that are concerning to the nurse and require follow up. ​

mass in abdomen pink tinged urine bp 120/84 weight 28 lbs

The nurse is caring for a child diagnosed with a Wilms tumor. Prior to treatment, the client is at highest risk for --- which could cause --

trauma to the tumor, spread of the cancer