A client receiving induction chemotherapy for high-tumor-burden Burkitt lymphoma has labs showing K 6.2, phosphate 6.8, calcium 7.4, uric acid 11.0. Which actions should the nurse anticipate? Select all that apply.
Select All That Apply
Choose your responses, then check the answer.
Explanation
TLS management: aggressive IV hydration to flush metabolites and maintain UO above 100 mL/hour, urate-lowering therapy with rasburicase (preferred over allopurinol when uric acid is high or risk is high), treat hyperkalemia per protocol with cardiac stabilization plus shifting plus removal, and prepare for renal replacement therapy if persistent. Asymptomatic hypocalcemia in TLS is usually NOT corrected because giving calcium with high phosphate causes calcium phosphate precipitation and AKI worsening — calcium is reserved for symptomatic hypocalcemia or membrane stabilization in hyperkalemia.