Wilms Tumor (Nephroblastoma)

Question 1

what is the most common renal tumor in children?

Answer 1

wilm’s tumor

Question 2

can you palpate a Wilm’s tumor?

Answer 2

NO, seeding

Question 3

when is a Wilm’s tumor most often seen?

Answer 3

children under 5

Question 4

Pathophysiology of a Wilm’s tumor

Answer 4

-rapidly growing malignancy
-considered a nephroblastoma
-typically unilateral
-metastasis through extension and the bloodstream

Question 5

prognosis of Wilms tumor

Answer 5

-usually has a 90% survival rate

Question 6

is hematuria a sign of a Wilm’s tumor?

Answer 6

yes

Question 7

clinical manifestations of Wilm’s tumor

Answer 7

-firm abdominal mass (asymmetry or visible in abdomen)
-hypertension (due to increased renin production)

Question 8

“W” in WAGR

Answer 8

Wilm’s

Question 9

“A” in WAGR

Answer 9

aniridia, lack of iris

Question 10

“G” in WAGR

Answer 10

genitourinary abnormalities

Question 11

“R” in WAGR

Answer 11

retardation

Question 12

medication that would preoperatively treat hypertension in Wilms tumor?

Answer 12

ACE inhibitors

Question 13

wilms tumor diagnostic testing

Answer 13

-renal & abdominal US
-CT or MRI to see if mets present
-24-hour urine collection (distinguish from neuroblastoma)
-blood levels (CBC, BUN, & creatinine)

Question 14

surgical repair of Wilm’s tumor

Answer 14

nephrectomy

Question 15

preop nursing considerations

Answer 15

-perfusion (monitor BP)
-renal function (monitor I&O)
-pain/discomfort
-nutrition
-fluid/electrolyte balance

Question 16

post op nursing considerations

Answer 16

-monitor I&O
-Monitor BUN & creatinine
-address concerns similar to any child post-abdominal surgery
-care related to chemotherapy and/or radiation therapy

Question 17

family education

Answer 17

the child will need to refrain from contact sports in the future

Question 18

post op complications to be aware of

Answer 18

-actelectisis
-ebiceration
-receiving chemo with one kidney