The child is receiving chemotherapy for acute lymphocytic leukemia. The nurse recognizes that a potential oncological emergency for this child would be tumor lysis syndrome. For which symptoms should the nurse monitor this child?
1. Respiratory distress and cyanosis
2. Thrombocytopenia and leukocytosis
3. Oliguria and altered levels of consciousness
4. Upper-extremity edema and neck vein distension
3
Rationale 1: Respiratory distress and cyanosis would be associated with space-occupying lesions or a hematologic emergency.
Rationale 2: Thrombocytopenia and leukocytosis occur with a hematological emergency.
Rationale 3: Tumor lysis causes a metabolic emergency. Because of electrolyte imbalance, the signs can be oliguria and altered levels of consciousness. Thrombocytopenia and leukocytosis occur with a hematological emergency.
Rationale 4: Upper-extremity edema and neck vein distension are not priority concerns for this client.
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