# 12 hours after induction chemotherapy for acute leukemia, which finding requires the nurse's immediate action? > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=498854&lang=en > language: en > subject: Adverse Effects/Contraindications/Interactions > category: PA ## Question 12 hours after induction chemotherapy for acute leukemia, which finding requires the nurse's immediate action? ## Option 1. Hemoglobin 8.9 g/dL with fatigue when walking to the bathroom 2. Platelet count 86,000/mm3 with scattered bruises on both forearms 3. Potassium 6.2 mEq/L with new peaked T waves on the cardiac monitor **✔ Correct answer** 4. White blood cell count 2,900/mm3 with an oral temperature of 37.2 C **Correct answer: 3** ## Explanation Rapid tumor breakdown can release intracellular potassium and cause lethal dysrhythmias. Potassium 6.2 mEq/L with peaked T waves is an active cardiac emergency requiring immediate notification, monitoring, and prescribed treatment. ## In-depth explanation Quick answer Treat hyperkalemia with electrocardiographic changes as the immediate tumor lysis emergency. Why this is correct Induction therapy can destroy many malignant cells at once, releasing potassium, phosphate, and nucleic acids. Peaked T waves show that the elevated potassium is already affecting cardiac conduction, so stabilization cannot wait for routine follow-up. Easy analogy or mental picture Tumor lysis is like many storage cells breaking open at once and flooding the electrical system. The analogy highlights the sudden electrolyte load but does not replace measurement of potassium, phosphate, calcium, uric acid, and kidney function. Memory hook After chemotherapy, high potassium plus ECG change means act now. NCLEX decision rule Prioritize a laboratory abnormality when it is paired with present organ dysfunction. In suspected tumor lysis syndrome, dysrhythmia risk outranks stable anemia, noncritical thrombocytopenia, or leukopenia without fever. Why the other choices are wrong The anemia and thrombocytopenia need follow-up but show no immediate instability. Leukopenia raises infection risk, yet the listed temperature does not indicate fever.References - [1]NCSBN: 2026 NCLEX-RN Test PlanNational Council of State Boards of Nursing - [2]NCI Dictionary of Cancer Terms: Tumor Lysis SyndromeNational Cancer Institute - [3]Tumor Lysis SyndromeNational Library of Medicine Bookshelf ## Related questions - [A nurse is reviewing the morning lab results for an adult client receiving warfarin for at…](https://mymerci.kr/pages/nclex_q.php?qn_id=360515&lang=en) - [A client is admitted to the emergency department after ingesting an unknown amount of acet…](https://mymerci.kr/pages/nclex_q.php?qn_id=362720&lang=en) - [A client with chronic heart failure is prescribed metoprolol 25 mg orally twice daily. Bef…](https://mymerci.kr/pages/nclex_q.php?qn_id=362756&lang=en) - [A 28-year-old client with type 1 diabetes receives regular insulin 6 units and NPH insulin…](https://mymerci.kr/pages/nclex_q.php?qn_id=362792&lang=en) - [A client receives IV vancomycin 1 g every 12 hours for MRSA bacteremia. Before the next do…](https://mymerci.kr/pages/nclex_q.php?qn_id=362833&lang=en) - [A client with bipolar disorder has been taking lithium carbonate 600 mg orally three times…](https://mymerci.kr/pages/nclex_q.php?qn_id=362894&lang=en) - [An 80-year-old male with heart failure is prescribed digoxin 0.125 mg daily. During mornin…](https://mymerci.kr/pages/nclex_q.php?qn_id=372686&lang=en) - [A 38-year-old female with rheumatoid arthritis is being discharged with a new prescription…](https://mymerci.kr/pages/nclex_q.php?qn_id=372687&lang=en) ## Read in another language - [en](https://mymerci.kr/pages/nclex_q.php?qn_id=498854&lang=en) - [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=498854&lang=ko) - [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=498854&lang=ja) - [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=498854&lang=zh-tw) - [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=498854&lang=vi) --- More free questions: [NCLEX-RN Practice](https://mymerci.kr/pages/nclex_bank.php?lang=en) _For study reference only. Always follow current clinical guidelines and your institution’s protocols._