HOCKENBERRY: WONG’S CLINICAL MANUAL OF PEDIATRIC NURSING, 2024 9TH EDITION UNIT 5 NEXT-GENERATION NCLEX® EXAMINATION-STYLE UNFOLDING CASE STUDIES 2024 CARE AT THE END OF LIFE

Day 1, 8:00 AM 1. A 9-year-old boy has paravertebral fibrosarcoma of the right lumbosacral area, complicated by paraplegia, urine retention, constipation, and neuropathic pain. He has a 5-month history of progressive lower back pain and swelling and paralysis of the lower limbs. The patient received and responded well to chemotherapy and radiotherapy, with a 40% regression in his tumor. However, the patient continued to suffer severe “burning/piercing” pain in the lower extremities, especially when the limbs were moved. He continues to require oral analgesics daily and remains bedridden with weakness of the lower extremities. Because of the clinically poor response and poor long-term prognosis, a decision was made by him and his family to focus on comfort and consult palliative care. Plans are for him to be discharged on hospice care once the pain is managed. The nursing admission assessment reveals the following results. Select the assessment findings that need further follow-up. Select all that apply. A. Temperature = 98.6°F (37.0°C) B. Blood pressure = 100/58 mmHg C. Heart rate = 124 beats/min D. Resp