NCLEX RN Practice Question # 558

NCLEX Examination.

Practice Question # 558.

NEPHROBLASTOMA (WILMS’ TUMOR)

Description

• Wilms’ tumor is the most common intra-abdominal and kidney tumor of childhood; itmay manifest unilaterally and localized or bilaterally, sometimes with metastasis to other organs (Fig. 46-2).
• The peak incidence is 3 years of age.
• Occurrence is associated with a genetic inheritance and with several congenital anomalies.
• Therapeutic management includes a combined treatment of surgery (partial to total nephrectomy) and chemotherapy with or without radiation, depending on the clinical stage and the histological pattern of the tumor.

Assessment

• Swelling or mass within the abdomen (mass is characteristically firm, nontender, confined to one side, and deep within the flank)
• Abdominal pain
• Urinary retention or hematuria or both
• Anemia (caused by hemorrhage within the tumor)
• Pallor, anorexia, and lethargy (resulting from anemia)
• Hypertension (caused by secretion of excess amounts of renin by the tumor)
• Weight loss and fever
• Symptoms of lung involvement, such as dyspnea, shortness of breath, and pain in the chest, if metastasis has occurred