Question

Multiple-choice question: While working one evening shift, the nurse caring for Amber notices a group of residents standing outside Amber's room reviewing her chart. When the nurse approaches them and asks them what they are doing, they respond "we heard this kid has a Wilms' tumor and we've never seen one. We want to look at it and palpate it." The nurse refuses to allow them to enter Amber's room and asks them all to leave the pediatric floor. In working with a child who has a Wilms' tumor, the nurse should caution health care workers against using palpation to assess the child because: A. Palpation will be painful. B. The lymph nodes may swell. C. Only physicians can feel the tumor. D. The tumor may spread if palpation is done.

Short answer

D. The tumor may spread if palpation is done.

Step-by-step solution

Understand the question

The question asks for the reason why nurses should caution health care workers against using palpation to assess a child with a Wilms' tumor.

Evaluate each option

A. Palpation will be painful: This could be true generally for tumors, but it's not the key issue specifically related to Wilms' tumors. \n B. The lymph nodes may swell: This is generally a common response to infections, not specifically related to palpation of a Wilms' tumor. \n C. Only physicians can feel the tumor: This is incorrect, any trained healthcare professional could theoretically feel a tumor. \n D. The tumor may spread if palpation is done: This is actually a key concern with Wilms' tumor. Palpating the abdomen may cause rupture of the tumor, leading cancer cells to spread in the abdomen.

Choose the correct answer

Given the above analysis, option D is the best answer. The specific reason why health care workers are cautioned against palpating a Wilms' tumor is because doing so may cause tumor rupture, leading to the spread of cancer cells.

Key concepts

Pediatric Oncology Nursing

Working in the field of pediatric oncology nursing requires a blend of advanced medical knowledge and a compassionate approach tailored to the young patients and their families. Nurses must understand the complex emotional and developmental needs of children as well as the intricacies of cancer treatments.

Pediatric oncology nurses are trained to deal with a variety of cancers, including Wilms' tumor—a rare kidney cancer that primarily affects children. In educating staff and family members, nurses should emphasize the importance of minimizing risk to the patient, such as avoiding unnecessary abdominal palpation due to the risk of tumor rupture and metastasis.

Critical aspects of pediatric oncology nursing include providing emotional support, simplifying medical jargon for understanding, managing side effects of treatment, and advocating for the needs of the child. These roles require continuous education and practice in understanding the latest treatment protocols and nursing care strategies.

Nursing Care for Wilms' Tumor

Wilms' tumor management is multidisciplinary, but nursing care is central to patient wellbeing. Since the abdomen's palpation can pose a risk, nurses must enact strict protocols to prevent the spread of malignant cells. This fundamental precaution is instrumental in nursing care for Wilms' tumor.

As primary caregivers, nurses oversee the holistic care plan, which includes pain management, postoperative care, administering chemotherapy or radiation therapy, and monitoring for complications. Moreover, nurses play a critical role in educating the family about the disease, treatment schedule, home care requirements, and crucial signs of complications that should prompt immediate medical attention.

The empathy and vigilance of oncology nurses often provide comfort during difficult times. By employing a thorough understanding of the disease's pathology, nurses can ensure high-quality, safe, and compassionate care for children with Wilms' tumor.

Unfolding Case Study in Nursing Education

Unfolding case studies are powerful educational tools in nursing education. They are designed to simulate real-life scenarios, allowing students to apply theoretical knowledge to practical, clinical situations. By mimicking the complexity and dynamism of actual patient care, these case studies facilitate critical thinking, decision-making, and adaptive learning among nursing students.

For example, an unfolding case study focusing on a pediatric oncology patient, such as a child with Wilms' tumor, allows students to analyze situations like the presented exercise. Students learn why specific actions, such as refusing unnecessary palpation, are crucial for patient safety. Through gradual complexity levels, learners can develop from fundamental knowledge to advanced practice skills in a controlled, reflective, and supportive learning environment.

By integrating unfolding case studies into nursing education, educators foster a deeper understanding of patient-centered care and the rationale behind various nursing actions and interventions.