Author Question: A child is diagnosed with a Wilms tumor. Which nursing action is most appropriate prior to surgery? ... (Read 79 times)

daltonest1984 · **on:** Jun 28, 2018

A child is diagnosed with a Wilms tumor. Which nursing action is most appropriate prior to surgery?

1. Careful bathing and handling
2. Monitoring of behavioral status
3. Maintenance of strict isolation
4. Administration of packed red-blood cells

Question 2

An adolescent is receiving methotrexate chemotherapy after undergoing limb-salvage surgery for osteogenic sarcoma. Which statement by the adolescent indicates understanding of the purpose of leucovorin therapy after the methotrexate?

1. I'm glad I only need one dose of the leucovorin.
2. I don't have any pain so I won't need to take the leucovorin this time.
3. I know I will be taking the leucovorin every 6 hours for about the next 3 days.
4. I don't have any nausea so I won't need the leucovorin.

shoemake · **Reply #1 on:** Jun 28, 2018

Answer to Question 1

Correct Answer: 1
Rationale: The tumor should never be palpated; careful bathing and handling are an important nursing consideration. Palpating the tumor can cause a piece of the tumor to dislodge. The child's behavior will not be affected with a Wilms tumor. The tumor does not cause excessive lowering of WBCs or RBCs, so strict isolation or administration of packed red-blood cells is not usually a nursing intervention.

Answer to Question 2

Correct Answer: 3
Rationale: Leucovorin (citrovorum factor) is a form of folic acid that helps to protect normal cells from the destructive action of methotrexate. It is started within 24 hours of methotrexate administration and is given along with hydration therapy. Usual administration is every 6 hours for 72 hours or until serum methotrexate is at the desired level.