The nurse is assessing a patient who has received the first dose of chemotherapy for leukemia.
Which patient's clinical findings indicate to the nurse that the patient has developed tumor lysis syndrome (TLS)?

Facial swelling and jugular vein distension (JVD).

Muscle weakness, confusion, polyuria, and polydipsia.

Flank pain, elevated uric acid, and cardiac monitor reveals an abnormal rhythm.

Elevated liver function tests, jaundice, and blistering skin rash.

Answer and Explanation

The Correct Answer is C

The correct answer is Choice C.

Choice A rationale

Facial swelling and jugular vein distension (JVD) are indicative of superior vena cava syndrome (SVCS), not tumor lysis syndrome (TLS). SVCS occurs when the superior vena cava, which carries blood from the head, neck, upper chest, and arms to the heart, is obstructed. This can lead to facial swelling, cyanosis, and distended neck veins due to increased venous pressure.

Choice B rationale

Muscle weakness, confusion, polyuria, and polydipsia are symptoms of hypercalcemia. Hypercalcemia is characterized by elevated levels of calcium in the blood, which can cause neuromuscular and cognitive symptoms, excessive urination, and increased thirst.

Choice C rationale

Tumor lysis syndrome (TLS) is characterized by rapid destruction of tumor cells, leading to elevated levels of uric acid, potassium, and phosphate. Symptoms include flank pain due to uric acid crystallization in the kidneys, and abnormal heart rhythms due to hyperkalemia.

Choice D rationale

Elevated liver function tests, jaundice, and blistering skin rash are symptoms of liver toxicity or hepatic dysfunction, possibly due to drug-induced liver injury. These symptoms are not related to tumor lysis syndrome (TLS).

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Correct Answer is A

Explanation

Choice A rationale

Dairy milk is a rich source of calcium, which is essential for patients with hypoparathyroidism. This condition leads to low levels of parathyroid hormone, causing hypocalcemia (low calcium levels in the blood). Including calcium-rich foods like dairy milk helps to manage this deficiency and maintain normal calcium levels.

Choice B rationale

Eggs provide some calcium, but their primary nutritional value is their protein content. While beneficial for overall health, eggs alone are not sufficient to address the calcium needs of patients with hypoparathyroidism, who require higher calcium intake.

Choice C rationale

Spinach contains calcium; however, it also has high levels of oxalates, which can bind to calcium and reduce its absorption in the body. Therefore, relying on spinach for calcium intake is not ideal for patients with hypoparathyroidism, who need to maximize calcium absorption to manage their condition effectively.

Choice D rationale

Green beans are nutritious and provide some calcium, but they are not among the top sources of calcium required for managing hypoparathyroidism. Patients with this condition need higher calcium intake from more concentrated sources like dairy products.

A. Refer the patient to the psychiatrist for anti-depressant medications. B. Provide portable oxygen therapy via nasal cannula during physical activity. C. Instruct the patient to increase their oral iron supplement dose until fatigue subsides. D. Encourage the patient to perform light exercises daily.

Correct Answer is B

Explanation

Choice A rationale

Referring the patient to a psychiatrist for anti-depressant medications may not address the immediate issue of fatigue and breathlessness related to acute leukemia. While psychological support is important, the primary focus should be on managing the patient's physical symptoms and improving oxygenation during activities.

Choice B rationale

Providing portable oxygen therapy via nasal cannula during physical activity is the best intervention for this patient. Oxygen therapy can help alleviate the patient's symptoms of breathlessness and fatigue by ensuring adequate oxygen levels during physical exertion. This intervention allows the patient to engage in activities with less discomfort and prevents further complications related to hypoxia.

Choice C rationale

Instructing the patient to increase their oral iron supplement dose until fatigue subsides is not appropriate without medical supervision. Iron supplementation should be based on the patient's iron levels and hematologic status. Over-supplementation can lead to adverse effects and may not address the underlying cause of fatigue in patients with acute leukemia.

Choice D rationale

Encouraging the patient to perform light exercises daily can be beneficial for overall health, but it may not be practical for someone experiencing severe fatigue and breathlessness. The patient's immediate need for oxygen support during activities takes precedence, and physical activity should be tailored to their current capabilities and medical condition. .

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The nurse is assessing a patient who has received the first dose of chemotherapy for leukemia.Which patient's clinical findings indicate to the nurse that the patient has developed tumor lysis syndrome (TLS)?

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Explanation

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Explanation

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The nurse is assessing a patient who has received the first dose of chemotherapy for leukemia.
Which patient's clinical findings indicate to the nurse that the patient has developed tumor lysis syndrome (TLS)?