Correct!
5. All of the above
The chest x-ray is normal but the high white blood cell count is highly suggestive of leukemia. Therefore, hematology/oncology consultation is indicated. Bone marrow biopsy would be necessary for diagnosis and choosing the correct antineoplastic therapy. IV fluids and allopurinol are appropriate to prevent tumor lysis syndrome which likely with chemotherapy.
The patient was admitted to the hospital, blood cultures obtained, cephepime empirically ordered (to be discontinued if blood cultures are negative) and a bone marrow biopsy scheduled for the following morning. However, at 1:30 AM the rapid response team was called because of complaints of the sudden onset of shortness of breath, palpitations, and chest pain. Vital signs showed an Sp02 of 98% with oxygen administered by blow, HR 133 beats/min, BP 105/63 mm Hg, RR 34 resp/min. Auscultation of the lung revealed bilateral crackles.
Which of the following are appropriate at this time? (Click on the correct answer to proceed to the fifth of seven panels)