Avoid abdominal palpation.
Encourage verbalization of feelings and fears; allow time for the child and family to cope with the disorder and the prognosis.
Provide comfort measures, as appropriate.
Provide adequate hydration and nutrition; offer a well-balanced diet with appropriate food choices and snacks.
Obtain a daily weight.
Anticipate the need for insertion of a central venous access device for chemotherapy administration. Prepare the child and family for insertion and provide central venous access site care, ensuring patency.
Institute safety and infection control precautions, as indicated.
Cluster nursing activities to ensure adequate rest periods, and allow time for uninterrupted rest. Gradually increase the child's activity, as tolerated.
Provide care measures to address nausea, vomiting, hair loss, and other adverse reactions to chemotherapeutic agents.
Obtain laboratory specimens to evaluate renal function preoperatively and postoperatively.
Prepare the child and family physically and psychologically for surgery, as appropriate. Explain preoperative and postoperative procedures and equipment.
Provide post-operative care, including surgical site care, vital signs, renal and gastrointestinal functioning, and pain management.
Axillary temperature assessment, pediatric
Blood pressure assessment, pediatric
Cardiopulmonary status monitoring, pediatric
Care plan preparation
Central venous access catheter flushing, pediatric
Central venous access catheter injection cap change, pediatric
Central venous access catheter insertion, assisting, pediatric
Central venous access catheter removal, pediatric
Central venous access device, declotting
Central venous access device dressing change
Chemotherapeutic drug administration, pediatric
IV bag preparation
IV catheter removal, pediatric
IV dressing change, pediatric
IV pump use
IV secondary line drug infusion
IV solution change
IV tubing change, pediatric
IV volume-control set preparation
Oral care, child age 3 and older
Oral care, toddler
Oral drug administration, older child
Oral drug administration, toddler
Oral temperature assessment, pediatric
Preoperative care, pediatric
Priming IV tubing
Pulse assessment, pediatric
Pulse oximetry, pediatric
Rectal temperature assessment, pediatric
Respiratory assessment, pediatric
Transfer to another room, pediatric
Weight measurement, child
Wound care, pediatric
the disorder, diagnosis, and treatment, including protocols for chemotherapy administration and possible radiation therapy (depending on the stage of the disease)
prescribed medications, including drug names, dosages, rationales for use, schedule of administration, and frequency and duration of therapy
possible adverse effects of chemotherapeutic regimen
the danger signs and symptoms to report to a practitioner
measures to minimize or prevent possible adverse effects of chemotherapy, such as the need to use a soft toothbrush and to avoid hot, spicy foods and commercial mouthwashes
signs and symptoms of infection
care of the surgical site, as indicated
the importance of protecting the remaining kidney from injury, such as avoiding such sports as boxing and hockey
signs and symptoms of abnormal bleeding
the importance of planned rest periods during the day
positive coping strategies
infection control precautions and measures to reduce the risk of infection
the recommended dietary plan
the importance of adhering to recommended follow-up, including visits, screening for treatment-related complications, and diagnostic testing, such as chest X-rays and abdominal ultrasounds every 6 to 8 weeks during therapy, then every 3 months for 2 years, and then every 6 months for an additional 2 years.