RUHS, Jaipur, M.Sc Nursing Entrance Exam-2022
Child Health Nursing (Pediatrics)
Easy
A "DO NOT PALPATE ABDOMEN" board is hanged for the child diagnosed with
Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2022
Explanation
- Wilms tumor (nephroblastoma) is a fragile, encapsulated kidney tumor found in children.
- Abdominal palpation poses a high risk of rupturing the tumor's capsule.
- Rupture can lead to seeding (spreading) of cancerous cells throughout the abdominal cavity, worsening the prognosis.
- Therefore, placing a 'DO NOT PALPATE ABDOMEN' sign is a critical safety measure to prevent iatrogenic harm.
Why Other Options Were Wrong
- Option A: Palpation is a key diagnostic procedure for intussusception, not a contraindication.
- Option B: Abdominal palpation is not contraindicated in megacolon (Hirschsprung disease) and is used to assess for distention and palpable fecal matter.
- Option D: Palpation is a necessary part of the assessment for an umbilical hernia.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Contraindications for Abdominal Palpation in Pediatric Conditions as background academic context rather than a clinical decision trigger.
- The primary nursing responsibility for a child with a suspected or confirmed Wilms tumor is to protect the abdomen from pressure. This includes careful handling, bathing, and positioning.
- Nurses must ensure the 'DO NOT PALPATE' sign is prominently displayed and must educate all team members, ancillary staff, and family about this critical precaution to prevent accidental rupture.
- What if? If the child had a neuroblastoma (another common childhood cancer), the abdomen is palpated, but carefully. The absolute, rigid contraindication to palpation is uniquely emphasized for Wilms tumor due to its highly fragile and encapsulated nature.
How to Approach the Question
- First, identify the core of the question: it asks for a condition where a specific, strict warning ('DO NOT PALPATE ABDOMEN') is necessary.
- Consider the pathophysiology of each option. Think about what each disease is and why touching the abdomen might be helpful or harmful.
- Recall that Wilms tumor is a soft, encapsulated kidney tumor. This makes it vulnerable to rupture from external pressure.
- Contrast this with the other options. For intussusception, palpation is diagnostic (finding a mass). For megacolon, it assesses stool burden. For umbilical hernia, it assesses reducibility.
- Conclude that the only condition where palpation is absolutely forbidden due to the risk of spreading cancer is Wilms tumor.
Concept Tested & Keywords
- Concept Tested: Contraindications for Abdominal Palpation in Pediatric Conditions
- Stem keywords: DO NOT PALPATE ABDOMEN, child
- Lead-in keywords: diagnosed with
- Clinical cues: Presence of a warning sign ('DO NOT PALPATE ABDOMEN')
- Negative lead-in flag: false
Question ID
QV0s8kNVTvRyHcIG8EPGhe
Reference Book
E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 304-306
E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 595-597
E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 82-84
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