After chemotherapy is begun for a child with acute leukemia, ...

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After chemotherapy is begun for a child with acute leukemia, prophylaxis to prevent acute tumor lysis syndrome includes which therapeutic intervention?
 
  a. Hydration
  b. Oxygenation
  c. Corticosteroids
  d. Pain management

Question 2

Nursing care of the child with myelosuppression from leukemia or chemotherapeutic agents should include which therapeutic intervention?
 
  a. Restrict oral fluids.
  b. Institute strict isolation.
  c. Use good hand-washing technique.
  d. Give immunizations appropriate for age.

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Answer to Question 1

ANS: A
Acute tumor lysis syndrome results from the release of intracellular metabolites during the initial treatment of leukemia. Hyperuricemia, hypocalcemia, hyperphosphatemia, and hyperkalemia can result. Hydration is used to reduce the metabolic consequences of the tumor lysis. Oxygenation is not helpful in preventing acute tumor lysis syndrome. Allopurinol, not corticosteroids, is indicated for pharmacologic management. Pain management may be indicated for supportive therapy of the child, but it does not prevent acute tumor lysis syndrome.

Answer to Question 2

ANS: C
Good hand washing minimizes the exposure to infectious organisms and decreases the chance of infection spread. Oral fluids are encouraged if the child is able to drink. If possible, the intravenous route is not used because of the increased risk of infection from parenteral fluid administration. Strict isolation is not indicated. When the child is immunocompromised, the vaccines are not effective. If necessary, the appropriate immunoglobulin is administered