A client with acute leukemia began combination chemotherapy yesterday. Today the nurse reviews the laboratory results: Exhibits Which condition should the nurse suspect?

Rationale: A. Septic shock is characterized by infection-related findings such as hypotension, fever or hypothermia, elevated lactate, and signs of poor perfusion. While lab abnormalities may occur, the hallmark electrolyte pattern seen here (hyperkalemia, hyperphosphatemia, hyperuricemia, and hypocalcemia) is not typical of septic shock. B. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) primarily causes dilutional hyponatremia and low serum osmolality. It does not typically present with elevated potassium, phosphorus, uric acid, and decreased calcium as seen in this client. C. Tumor lysis syndrome occurs when large numbers of cancer cells are rapidly destroyed by chemotherapy, releasing intracellular contents into the bloodstream. This leads to hyperuricemia, hyperkalemia, hyperphosphatemia, and secondary hypocalcemia. These exact laboratory abnormalities are present in this client, making this the correct diagnosis. This is a medical emergency due to risk of acute kidney injury and cardiac dysrhythmias. D. An anaphylactic reaction to chemotherapy would present with acute symptoms such as hypotension, bronchospasm, rash, and airway compromise. It does not cause the specific electrolyte disturbances seen in this scenario.