Today’s NCLEX-RN® question of the day focuses on a nurse reviewing laboratory results on an oncology unit.
The nurse is reviewing the blood work drawn for a client on the oncology unit. The nurse should recognize which laboratory result correlates with a diagnosis of tumor lysis syndrome (TLS)?
A. Phosphorus level of 4.4 mg/dL
B. Potassium level of 6.1 mEq/L
C. Calcium level of 8.4 mg/dL
D. Uric acid level of 6.9 mg/dL
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The correct answer to today’s NCLEX-RN® Question is…
B. Potassium level of 6.1 mEq/L
Rationale: TLS is a metabolic complication resulting from a rapid release of intracellular components, such as potassium, in response to chemotherapy. Potassium greater than 6 mEq/L correlates with a diagnosis of TLS. Normal potassium levels are 3.5-5.1 mEq/L.
Main takeaway
Tumor lysis syndrome (TLS) is a metabolic complication that results in the rapid release of intracellular components such as phosphate, potassium, and uric acid into the blood due to chemotherapy. Diagnosis of TLS begins with history and clinical findings. A complete metabolic panel (CMP) will be drawn to assess for electrolyte imbalance. TLS is indicated by calcium less than 7 mg/dL (normal levels are 8.4-10.6 mg/dL), uric acid greater than 8 mg/dL (normal levels are 2.0-7.0 mg/dL), phosphorus greater than 6.5 mg/dL (normal levels are 3.0-4.5 mg/dL), and potassium greater than 6 mEq/L (normal levels are 3.5-5.1 mEq/L).
Incorrect answer explanations
A. Phosphorus level of 4.4 mg/dL
Rationale: Although phosphorus is one of the intracellular components released from the cells during TLS, normal levels are 3.0-4.5 mg/dL. Therefore, this is not consistent with TLS.
C. Calcium level of 8.4 mg/dL
Rationale: Although calcium is one of the intracellular components affected by TLS, normal levels are 8.4-10.6 mg/dL. Therefore, this is not consistent with TLS.
D. Uric acid level of 6.9 mg/dL
Rationale: Although uric acid is one of the intracellular components released from the cells during TLS, normal levels are 2.0-7.0 mg/dL. Therefore, this is not consistent with TLS.
References
Lewis, S.L., Bucher, L., Heitkemper, M.M., & Harding, M.M. (2020). Medical-surgical nursing: Assessment and management of clinical problems (11th ed.). St. Louis, MO: Elsevier.
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