Which test result would the nurse least likely expect to find in ...

[kshipps]

Which test result would the nurse least likely expect to find in a child diagnosed with Wilms tumor?
 
  A) Complete blood count (CBC) within normal limits
  B) Urinalysis positive for blood
  C) Mass on kidney
  D) Elevated homovanillic acid (HVA) with 24-hour urine collection

Question 2

Which of the following would be most appropriate to include in the plan of care for a child who has undergone surgery for removal of an astrocytoma?
 
  A) Elevating the foot of the bed
  B) Positioning the child on his unaffected side
  C) Raising the head of the bed at least 45 degrees
  D) Administering large volumes of intravenous fluids

[javimendoza7]

Answer to Question 1

D
Feedback:
Levels of HVA and vanillylmandelic acid (VMA) will not be elevated with Wilms tumor; they are elevated with neuroblastoma. CBC, blood urea nitrogen (BUN), and creatinine usually are within normal limits. Urinalysis may reveal hematuria or leukocytes. Renal or abdominal ultrasound would reveal a mass on the kidney.

Answer to Question 2

B
Feedback:
Postoperatively, the nurse should position the child on his unaffected side, with the head of the bed flat or at the level prescribed by the neurosurgeon. The foot of the bed is not elevated to prevent increasing intracranial pressure and contributing to bleeding. Fluids are administered carefully to avoid excess fluid intake, which would cause or worsen cerebral edema.

[kshipps]

Excellent

[bulacsom]

TYSM