A child is getting induction therapy for Burkitt lymphoma.The nurse finds the child lethargic and complaining of side and back pain.The child's morning laboratory results indicate a serum calcium level of 7.2 mg/dL.What actions by the nurse are the most appropriate at this time? (Select all that apply.)

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This child is manifesting signs of tumor lysis syndrome.The child is at risk due to the rapid destruction of cancer cells (induction therapy)and from the child's type of cancer (Burkitt lymphoma).Lethargy,flank pain,and hypocalcemia are common findings in this condition.The nurse should administer pain medication,assess for physical manifestations of hypocalcemia (Chvostek and Trousseau signs),and prepare to administer allopurinol.Adequate hydration is important as well,but because the child is lethargic,IV fluids should be given,not oral fluids.The rapid response team is not needed at this point.

A Child Is Getting Induction Therapy for Burkitt Lymphoma