Advanced Oncology Certified Nurse Practitioner (AOCNP) Certification Practice Test

Which vital sign monitoring is critical for managing TLS?

1. Blood pressure

2. Heart rate

3. Oxygen saturation

4. Continuous ECG monitoring

The correct answer is: Continuous ECG monitoring

Continuous ECG monitoring is critical for managing tumor lysis syndrome (TLS) due to the electrolyte imbalances that can occur as a result of the rapid destruction of tumor cells. When tumor cells break down, they release intracellular contents into the bloodstream, leading to hyperuricemia (high uric acid), hyperkalemia (high potassium), hyperphosphatemia (high phosphate), and hypocalcemia (low calcium). These alterations in electrolytes can cause significant cardiovascular complications, including arrhythmias. By continuously monitoring the ECG, healthcare providers can detect any rhythm disturbances or changes in heart rate that may indicate complications arising from these electrolyte imbalances, allowing for timely interventions. Early detection of arrhythmias can be vital in preventing more severe cardiac issues, thus highlighting the importance of continuous ECG monitoring in patients at risk for or experiencing TLS. Monitoring of blood pressure, heart rate, and oxygen saturation, while important, does not specifically address the immediate cardiovascular risks associated with the unique electrolyte disturbances seen in TLS. Therefore, continuous ECG monitoring stands out as the most critical approach in this scenario.