A 12-year-old undergoing chemotherapy for leukemia presents to the Emergency Department with blood in his urine. Which of the following interventions would the nurse perform first?
1. Explain to the child that this is a common side effect of chemotherapy.
2. Calculate a 24-hour intake and output.
3. Request an order for IV fluids.
4. Report this finding to the physician immediately.
4
Rationale:
1. Blood in the urine is not an acceptable side effect of chemotherapy.
2. Calculating I/O is a routine nursing intervention, and is not specific to treatment for blood in the urine.
3. The child should have been adequately hydrated prior to the most recent chemotherapy. Unless nausea and vomiting are present, oral fluids should be encouraged before the administration of IVF.
4. This could signify tumor lysis syndrome, and is a potential emergency that should be reported quickly.
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