Question

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Three year old Danica arrives to your oncology floor. She is currently receiving chemotherapy for bilateral Wilm's Tumor that she was diagnosed with six weeks ago. Her surgery is scheduled next week. Her CC (chief complaint) on arrival to the ED today was fever (103.1F). Her ANC is 412.

1. What is Wilm's Tumor and what kind of symptoms does it usually present with?

2. What results do you think you should be looking for in her chart? (Think what are infection markers, how would you test them?, etc, etc)

3. What are three nursing diagnoses for Danica? What are two interventions PER nursing diagnosis for Danica? (Total 3 ND, 6 interventions)

4. Danica requires fever control, she weighs 28 pounds. Her dose of acetaminophen for fever control is 15mg/kg. What is her dose?

5. Your tylenol is packaged 160mg/5mL. How much do you draw up?

6. Why might Ibuprofen be contraindicated for her?

Answer 1

1.wilm's tumor:

wilm's tumoa:- is abo called as nephaoblastoma, * canuu The kidnay hatpicaly Occus childaen 9agely in aduts wilmis Jumo acun altusation o enes suih as The wilms Tumoa causis as husul 9 or wilms tumor 2 (TA U) 04 ten ad4ec childaan Lommon a4t aa 3 to 4 and k as

symptoms of wilm's tumor:

• loss of appetite,
• abdominal pain,
• high fever,
• painless,palpable abdominal mass,
• Hematuria - blood present in the urine.
• blood pressure increase.

2.infective markers in wilms tumor:

(10/iG Tmmun UdS 03 LAL pabiea bat Biomakus $yst.m ion CD4 4 vS P CNA Genetic Bfomakus: 1 gan funection Ancuplidy A Dec- mutation P1otrin Biomaleus a AFb-1 BeL-2 BR-I FAS

laboratory test for wilms tumor:

lobonatosy tist Po wims tumo Blood uin test 50c126do20 uoD Bucbkay ultsa sound Computud tomognaphy (T) sian rormur ialo Magneti Susonanu Tmagg (NRy 5 uAA W of BioPy chaomasomTesb (ouB ic

3.three nursing diagnosis;

Risk or letion elated Tomunoaupprussion seonday to chemo Thesapeutic dhus Rist dor auti Pai elatid ts swgtcal sit R fer fatigu ulatd to dhug herapy anel diseas Aat na Rish 40 4mit Aulatid t diagn Theatmert 9sd -3 &0 I naitsn

intervention for eilms tumor:

• prevent transfer of microorganism.
• prevent oral trauma.
• prevent anxiety.
• prevent injury.