Today’s NCLEX-RN® question of the day focuses on a nurse caring for a group of clients in the oncology unit. Which client is most likely to develop tumor lysis syndrome (TLS)? Can you figure it out?
The nurse is caring for a group of clients on the oncology unit. Which client is most likely to develop tumor lysis syndrome (TLS)?
A. An 82-year-old client diagnosed with acute leukemia receiving chemotherapyB. A 34-year-old client in remission for 6-months for breast cancer
C. An 8-year-old client newly diagnosed with stage I bone cancer
D. A 42-year-old client with a history of alcohol abuse diagnosed with melanomaScroll down for the correct answer!
The correct answer to today’s NCLEX-RN® Question is…
A. An 82-year-old client diagnosed with acute leukemia receiving chemotherapy
Rationale: TLS is most often caused by chemotherapeutic treatment of hematological malignancies, such as leukemia. A diagnosis of leukemia paired with older age puts this client at the highest risk.
Major Takeaway
Tumor Lysis Syndrome (TLS) is caused by a complication during treatment of hematological malignancies, such as leukemia and lymphoma, when chemotherapeutic medications rapidly kill large numbers of tumor cells at once. There are some factors that may put clients at risk of TLS, such as older age and having a large tumor burden, which can be evidenced by the presence of a very high white blood cell count and high lactate dehydrogenase (LDH), as well as bone marrow involvement by the malignancy. Finally, the risk of TLS is also higher with the use of substances that increase the uric acid levels in blood, such as alcohol and medications like thiazide diuretics or levodopa.
Incorrect answer explanations
B. A 34-year-old client in remission for 6-months for breast cancer
Rationale: This client is in remission and is not at the highest risk for TLS compared to another client.
C. An 8-year-old client newly diagnosed with stage I bone cancer
Rationale: Although risk for TLS increases as bone marrow involvement by the malignancy occurs, this client is not at the highest risk for TLS compared to another client.
D. A 42-year-old client with a history of alcohol abuse diagnosed with melanoma
Rationale: Although alcohol abuse does increase the risk of developing TLS, there is another client who is at a higher risk of developing TLS. TLS is not commonly associated with melanoma.
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