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)?

Choice A rationale

Placing the patient in a private, lead-lined room is unnecessary for external radiation therapy, which does not make the patient radioactive. This consideration is more applicable to internal radiation therapy (brachytherapy), where radioactive materials are placed inside the body.

Choice B rationale

While dosimeter badges are essential for monitoring radiation exposure, they are more relevant for healthcare workers who may be exposed to radiation, not for patients receiving external radiation therapy. The patient themselves are not a source of radiation exposure.

Choice C rationale

Monitoring the patient's skin integrity is crucial because external radiation can cause skin irritation and damage. Avoiding exposure to extreme heat or cold helps prevent additional skin trauma and promotes healing.

Choice D rationale

Restricting visitors and posting radioactive precautions signs are unnecessary for patients receiving external radiation therapy. These precautions are more applicable to internal radiation therapy, where the patient may emit radiation.

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).