A child is getting induction therapy for Burkitt lymphoma. The ...

[chads108]

A child is getting induction therapy for Burkitt lymphoma. The nurse finds the child lethargic and complaining of side and back pain. The child's morning laboratory results indicate a serum calcium level of 7.2 mg/dL.
 
  What actions by the nurse are the most appropriate at this time? (Select all that apply.)
  A.
  Administer a dose of pain medication.
  B.
  Assess Chvostek and Trousseau signs.
  C.
  Call the rapid response team.
  D.
  Encourage an increased oral intake.
  E.
  Prepare to administer allopurinol (Aloprim).

Question 2

The staff nurse is educating nursing students on the long-term effects of childhood chemotherapy. Which problems does the nurse include in the educational session? (Select all that apply.)
 
  A.
  Cardiac dysfunction
  B.
  Hearing loss
  C.
  Increased risk of multiple-gestation pregnancies
  D.
  Learning disabilities
  E.
  Peripheral neuropathy

[helenmarkerine]

Answer to Question 1

ANS: A, B, E
This child is manifesting signs of tumor lysis syndrome. The child is at risk due to the rapid destruction of cancer cells (induction therapy) and from the child's type of cancer (Burkitt lymphoma). Lethargy, flank pain, and hypocalcemia are common findings in this condition. The nurse should administer pain medication, assess for physical manifestations of hypocalcemia (Chvostek and Trousseau signs), and prepare to administer allopurinol. Adequate hydration is important as well, but because the child is lethargic, IV fluids should be given, not oral fluids. The rapid response team is not needed at this point.

Answer to Question 2

ANS: A, B, D, E
The list of long-term effects of chemotherapy is lengthy and includes cardiac dysfunction, hearing loss, learning disabilities, and peripheral neuropathy, among others. Sterility, not an increased risk for multiple-gestation pregnancies, is also an effect.