Choice C is correct. Abdominal palpation is contraindicated in the client with a nephroblastoma. This is because the tumor is located in the abdominal cavity, and by palpating it, you can disturb the tissue and cause cells from the tumor to break loose and spread to other parts of the body. The nurse should not perform abdominal palpation on a client with a nephroblastoma.

Choice A is incorrect. There is no contraindication for checking the capillary refill in the client with nephroblastoma. By checking their capillary refill, you will be assessing their perfusion status, which is very important.

Choice B is incorrect. There is no contraindication for auscultating heart sounds in the client with nephroblastoma. Furthermore, you will be able to assess for the presence of an S3 heart sound, which indicates fluid overload and should be avoided in this client.

Choice D is incorrect. There is no contraindication for assessing urine color in the client with nephroblastoma. This will be a critical assessment. Since this tumor is on the kidney, assessing for adequate urine production and hematuria is very important. Hematuria is a common finding in clients with nephroblastoma and the nurse should assess for this and report it to the healthcare provider.

✓ Handle the client with care and avoid palpating the abdomen or applying pressure to the tumor site to prevent potential pain or discomfort.

✓ Collaborate with the healthcare team to assess and manage any pain or discomfort the client may be experiencing due to the tumor or its treatment.

✓ Offer emotional support to both the client and their family, as a diagnosis of stage IV nephroblastoma can be challenging.

✓ Provide information about support groups, counseling services, and resources available to families of children with cancer.