A pediatric client is receiving chemotherapy for acute ...

[savannahhooper]

A pediatric client is receiving chemotherapy for acute lymphocytic leukemia. While providing care for this client, which clinical manifestations would indicate tumor lysis syndrome?
 
  Select all that apply.
  A) Thrombocytopenia
  B) Altered levels of consciousness
  C) Respiratory distress
  D) Oliguria
  E) Upper-extremity edema

Question 2

An adult client reports to the nurse an inability to tolerate usual exercise and the feeling of fatigue. The client states that these symptoms have been gradual over time. Which physical assessment findings, along with the client's verbal complaints, woul
 
  Select all that apply.
  A) Joint pain
  B) Pallor
  C) Splenomegaly
  D) Abnormal bleeding
  E) Edema

[juwms]

Answer to Question 1

Answer: B, D

Tumor lysis causes a metabolic emergency. Because of electrolyte imbalance, the signs can be oliguria and altered levels of consciousness. Thrombocytopenia occurs with a hematological emergency. Space-occupying lesions can cause respiratory distress and upper-extremity edema.

Answer to Question 2

Answer: B, C, E

The symptoms for CML are insidious and occur over time, affecting older adults. The client may exhibit splenomegaly, pallor, edema, and lymphadenopathy. Bone and joint pain with abnormal bleeding are characteristics of AML, which also occurs in older clients.