Cancer Complications: Tumor Lysis Syndrome

Question 1

What happens with this?

Answer 1

Large amounts of tumor cells rapidly killed by chemo, then large amounts of potassium, phosphate, and uric acid are released into circulation

Question 2

What is released into circulation when the chemo is killing the tumor cells?

Answer 2

Potassium
Phosphate
Uric acid

Question 3

High levels of uric acid= ?

Answer 3

Damage to kidneys

Question 4

When would TLS likly occur?

Answer 4

After FIRST cycle of chemo

Question 5

S/S

Weight loss or gain?

Answer 5

Gain

Question 6

S/S

Cachexia or edema?

Answer 6

Edema

Question 7

S/S

Diarrhea or constipation?

Answer 7

Diarreha

Question 8

S/S

Energy or lethargy?

Answer 8

Lethargy

Question 9

S/S

Muscle ___

Answer 9

Cramps

Question 10

S/S

What abdominal issues?

Answer 10

NV

Question 11

S/S

Weakness or strenght?

Answer 11

Weaknes

Question 12

S/S

How is UO?

Answer 12

Oliguria

Question 13

S/S

T/F: Seizures

Answer 13

True

Question 14

S/S

What positive signs?

Answer 14

Chovstek

Trosseau

Question 15

What is chovstek sign?

Answer 15

Twitching of facial muscle in response to tapping over the area of facial nerve

Question 16

What is trousseau sign?

Answer 16

Carpopedal spasm caused by inflating the BP cuff to a level above systolic pressure for 3 min

Question 17

S/S

Hypo or hyperactive DTR?

Answer 17

Hyperactive

Question 18

S/S

What is heart like?

Answer 18

Dysrhythmias–watch ECG

Question 19

Management?

Answer 19

Education

Question 20

Prevention

What should oral intake be–decreased or increased?

Answer 20

Increased!!!

Question 21

Prevention

Drink more—how much?

Answer 21

3000-5000

Question 22

Prevention

Consistent schedule of what?

Answer 22

Fluid intake

*may need IV saline if can’t drink enough

Question 23

Prevention

What hydration?

Answer 23

Isotonic saline

Question 24

What diet restrictions?

Answer 24

Low phosphate and K+ in foods

Question 25

Treatment?

Answer 25

Electrolyte imbalance tx

Question 26

What safety precautions?

Answer 26

Seizure precautions

Question 27

T/F: May need dialysis

Answer 27

T

Question 28

What drugs?

Answer 28

Diuretics
Uric acid excretion
Vasopressor
Reduce K+ levels

Question 29

What diuretic and why?

Answer 29

Osmotic (mannitol) for treating edema

Question 30

What uric acid excretion drug?

Answer 30

Allopurinol

Question 31

What vasopressor?

Answer 31

Dopamine

Question 32

How to reduce K+ levels?

Answer 32

Sodium polystyrene sulfonate

IV insulin and IV D50