Pediatric Nursing Q 199

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A child is diagnosed with Wilms’ tumor. During assessment, the nurse in charge expects to detect:

  

     A. Gross hematuria

     B. Dysuria

     C. Nausea and vomiting

     D. An abdominal mass

    

    

Correct Answer: D. An abdominal mass

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The most common sign of Wilms’ tumor is a painless, palpable abdominal mass, sometimes accompanied by an increase in abdominal girth. Wilms tumor usually presents as an asymptomatic abdominal mass in the majority of children. The mother may have discovered the mass during bathing the infant.

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Option A: Gross hematuria is uncommon, although microscopic hematuria may be present. Abdominal pain is the most common initial presenting symptom (30% to 40%), followed by hypertension (25%) and hematuria (12% to 25%).

Option B: Dysuria is not associated with Wilms’ tumor. Wilms tumor, or nephroblastoma, is the most common renal cancer in the pediatric age group. It is also the most common pediatric abdominal cancer and the fourth most common pediatric cancer overall.

Option C: Nausea and vomiting are rare in children with Wilms’ tumor. The cause of Wilms tumor is not precisely known, but it is believed to be due to genetic alterations that deal with the normal embryological development of the genitourinary tract.

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