The home health nurse should examine a patient discharged after treatment for non-Hodgkin's lymphoma for signs of which complication?

• A. Tumor lysis syndrome
• B. Syndrome of inappropriate antidiuretic hormone (SIADH)
• C. Disseminated intravascular coagulation (DIC)
• D. Hypercalcemia

Answer: (A)

Tumor lysis syndrome is the risk to watch for after treatment of a rapidly dividing cancer like non-Hodgkin’s lymphoma. When a lot of tumor cells are killed quickly, their contents spill into the bloodstream, causing a surge of uric acid, potassium, and phosphate and a drop in calcium. This can lead to kidney injury and serious electrolyte problems. In a home health setting, signs to monitor include decreased urine output, flank or groin pain, nausea or vomiting, fatigue, and confusion, with labs showing hyperkalemia, hyperphosphatemia, hyperuricemia, and hypocalcemia. This constellation specifically follows rapid tumor cell breakdown after therapy, which is why it’s the most likely complication to assess for.

SiADH would produce hyponatremia and fluid overload symptoms; DIC involves bleeding and abnormal clotting tests; hypercalcemia presents with weakness, dehydration, constipation, and polyuria—none of these tightly align with the immediate post-treatment risks of a rapidly lysing lymphoma tumor as TLS does.