A patient has been admitted with tumor lysis syndrome (TLS). Which intervention would be incorporated into the plan of care to prevent the metabolic imbalances associated with this disorder?
Restrict foods containing potassium.
Give sodium polystyrene sulfonate for hypokalemia.
Keep urine pH below 7.0.
Restrict all oral fluids.
The Correct Answer is A
Choice A rationale
Restricting foods containing potassium helps prevent hyperkalemia, a common metabolic imbalance in tumor lysis syndrome (TLS) due to the rapid release of intracellular potassium from lysed tumor cells.
Choice B rationale
Giving sodium polystyrene sulfonate is used to treat hyperkalemia, not hypokalemia. It works by binding potassium in the gut and helping excrete it from the body, but it is not a preventive measure for metabolic imbalances in TLS.
Choice C rationale
Keeping urine pH below 7.0 is not recommended for TLS. Alkalinizing the urine to a pH above 7.0 helps prevent uric acid crystallization and renal damage, which is crucial in managing TLS.
Choice D rationale
Restricting all oral fluids is not advisable for TLS. Adequate hydration is essential to support kidney function and enhance the excretion of electrolytes and uric acid, which helps prevent and manage TLS.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","D","E"]
Explanation
Choice A rationale: Oral health indicates the absence of mucositis or other oral complications, which is good, but it doesn't necessarily reflect overall improvement in the client's cancer or chemotherapy response.
Choice B rationale: The absence of bleeding episodes is significant. This suggests that the client's platelet count has improved, reducing the risk of bleeding, which is an important indicator of recovery.
Choice C rationale: While weight maintenance or gain can be an indicator of health improvement, the slight decrease in weight from January to February (70.5 kg to 69 kg) does not suggest an improvement.
Choice D rationale: An increase in the WBC count to within the normal range (4.2 x 10⁹/L) is a positive sign. It indicates that the client’s immune system is recovering, which is crucial during chemotherapy.
Choice E rationale: The improvement in platelet count to within the normal range (150 x 10⁹/L) suggests a reduced risk of bleeding and reflects better bone marrow function, which is a positive outcome of the treatment.
Correct Answer is A
Explanation
Choice A rationale
Monitoring the client’s hydration status is critical for older adults, especially those on a medical-surgical unit, to prevent dehydration, which can lead to serious complications such as renal impairment, confusion, and electrolyte imbalance.
Choice B rationale
Encouraging physical activities is beneficial but is not always feasible or safe for all older clients, especially those with certain medical conditions or mobility limitations.
Choice C rationale
Administering medications as prescribed is essential but is a standard practice for all clients and not specific to older adults' unique needs.
Choice D rationale
Educating the client on dietary needs is important but secondary to monitoring hydration, which addresses more immediate physiological needs and complications.
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