The nurse is assessing a patient with prostate cancer who is receiving chemotherapy.
What findings will the nurse identify as potential toxicities of this treatment? Select All That Apply.

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.

Choice A rationale

Tumor lysis syndrome (TLS) results from the rapid breakdown of cancer cells, leading to metabolic imbalances such as hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia. Symptoms can include nausea, vomiting, diarrhea, muscle cramps, and arrhythmias. TLS is a metabolic emergency seen in high-turnover cancers like leukemia or lymphoma and is not associated with symptoms like jugular venous distention or edema in the face, neck, and arms.

Choice B rationale

Hypercalcemia, often due to bone metastasis or certain paraneoplastic syndromes, presents with symptoms such as confusion, lethargy, constipation, nausea, polyuria, and polydipsia. It is not related to the symptoms described in the question, which are indicative of a different oncologic emergency.

Choice C rationale

Spinal cord compression occurs when a tumor compresses the spinal cord, leading to symptoms like severe back pain, weakness, sensory changes, and autonomic dysfunction. It does not explain the symptoms of jugular venous distention, facial, neck, and arm edema.

Choice D rationale

Superior vena cava syndrome (SVCS) occurs when a tumor compresses the superior vena cava, leading to decreased venous return from the upper body. Symptoms include shortness of breath, jugular venous distention, and edema of the face, neck, and arms due to impaired blood flow. This is an oncologic emergency requiring prompt intervention to reduce the obstruction.