Which of the following pathophysiologic events contributes to renal failure associated with tumor lysis syndrome?
a. Hypocalcemia
b. Elevated white blood cell count
c. Metabolic acidosis
d. Crystallization of uric acid in the renal tubules
D
When therapy is initiated, tumor cell destruction releases nucleic acids, which are metabolized into uric acid. Metabolic acidosis ensues, resulting in crystallization of the uric acid in the distal tubules of the kidneys and leading to obstruction of urine flow. Glomerular filtration rates drop as the kidneys are unable to clear the increasing amounts of uric acid. Consequently, acute kidney injury eventually occurs.
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The physician orders paclitaxel (Taxol) 135 mg/m2 to be administered over 24 hours. The client's body surface area is 1.62 m2. The medication is supplied 6 mg/mL. How many mL would you administer?
1. 1312.2 mL 2. 13.9 mL 3. 36.5 mL 4. 0.14 mL
A nurse is caring for a 55-year-old client with Parkinson's disease who is prescribed entacapone. The nurse would monitor this client for which adverse reaction?
A) Increased hand tremor B) Constipation C) Urinary retention D) Dyskinesia
The nurse performing a physical assessment of a client's cardiac system is auscultating the carotid arteries for the presence of bruits. What sound would the nurse expect to hear if a bruit is present?
A. A swishing sound resulting from narrowing of the artery B. A pulsating sound resulting from increased arterial pressure C. A whistling sound resulting from a stiff noncompliant artery D. A gurgling sound resulting from blood bypassing an aneurysm
What are the most commonly accepted ethical standards for making decisions on behalf of children? Choose two
a. substituted judgment b. standard of best interest c. surrogate decision making d. living will preferences