A child has Wilms' tumor and is scheduled for surgery. Which of the following actions should the nurse include in the plan of care?

Correct Answer: D

Rationale: In caring for a child with Wilms' tumor scheduled for surgery, the nurse should include avoiding palpating the abdomen in the plan of care. The correct answer, option D, is essential to prevent the risk of tumor rupture and dissemination of cancer cells. Palpation can potentially lead to seeding of tumor cells into adjacent tissues or blood vessels, increasing the risk of metastasis. Repositioning the child frequently, as in option B, is a general care measure to prevent pressure ulcers but is not directly related to the child's condition or surgery. Option A, palpating the abdomen daily for tumor size, is contraindicated as it can cause harm as mentioned earlier. Option C, preparing the child for chemotherapy, is also incorrect as the child is scheduled for surgery, not chemotherapy. In a pediatric nursing context, it is crucial to prioritize interventions that promote the well-being and safety of the child. Understanding the specific needs of a child with Wilms' tumor, such as the risk of tumor manipulation, guides the nurse in providing safe and effective care. By selecting option D, the nurse ensures that the care plan aligns with best practices and minimizes potential complications for the child undergoing surgery for Wilms' tumor.

Correct Answer: D

Rationale: The correct instruction for a child with contact dermatitis is to apply a thin layer of corticosteroid cream to the affected area. Corticosteroid cream helps reduce inflammation and itching associated with contact dermatitis. It is important to avoid using antibiotic ointment or rubbing the skin vigorously, as these can worsen the condition. Keeping the child's skin dry is generally a good practice, but in the case of contact dermatitis, corticosteroid cream application is more beneficial.

Correct Answer: B

Rationale: Changing the child's position frequently is essential for preventing respiratory tract infections and reducing pressure on delicate skin, which are common risks for edematous children with reduced mobility due to nephrotic syndrome. This intervention helps promote circulation and prevents complications associated with prolonged immobility.

Correct Answer: A

Rationale: In the case of a child who has undergone a nephrectomy, which is the surgical removal of a kidney, the nurse should caution the parents that the child will have to avoid engaging in contact sports. This caution is important because contact sports pose a risk of injury to the remaining kidney due to physical impact or trauma. Protecting the remaining kidney from injury is crucial to maintaining the child's renal function and overall health. Option B, horseback riding, is not the most correct answer because while it does involve some physical activity and potential for falls, it does not inherently involve the same level of direct physical contact and impact as contact sports. Option C, alcohol, while generally not recommended for children, is not directly related to the risk of injury to the remaining kidney post-nephrectomy. Option D, diuretic medications, may actually be necessary post-nephrectomy to help manage the child's fluid balance and kidney function, so it is not something that the child necessarily needs to avoid. In a pediatric nursing context, it is crucial for nurses to provide thorough education to parents about post-operative care following a nephrectomy. By understanding the specific risks and precautions associated with their child's condition, parents can help ensure the best possible outcomes for their child's health and well-being.

Correct Answer: C

Rationale: The correct action is to notify the healthcare provider in charge of this occurrence of paraphimosis. Paraphimosis is a urologic emergency where the foreskin is retracted and becomes tight, potentially impeding blood flow to the penis. It is crucial to seek medical intervention promptly to prevent complications.