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Flashcards in oncological emergencies Deck (21)
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1

pericardial effusion

due to spread of cancer there is decreased space in the pericardium, this can lead to cardiac tamponade

2

signs and symptoms of pericardial effusion

dyspnea, cough, orthopnea, chest discomfort, JVD, tachycardia, muffled heart sounds, liver engorgement, friction rub, pulmonary edema, pulsus paradoxus, progressive hypotension/shock
cxr, EKG

3

treatment of cardiac tamponade

corticosteriods, diruetics, NSAIDs, pericardial window, pericardialcentesis, aspiration/testing of fluid to ensure it is cancerous, pericardectomy

4

complications associated with pericardectomy

anesthesia risk
dysrythmia
bleeding
infection
hemothorax

5

sclerotherapy

injected into the pericardium to "harden" prevents reaccumilation of fluid

6

complications of sclerotherapy

localized pain, fever, PVCs, pericarditis, myelosuppression

7

superior vena cava syndrome

caused by obstruction of blood flow through the superior vena cava
common cause- malignancy with compression of the vessel by tumor or lymph node mass
lymph chains in chest w

8

s/s of superior vena cava syndrome

face edema, upper arms, chest, collateral veins in neck of chest visible, metal stents may be placed percutaneous, patient with mental status change, ICP, or upper airway constriction

9

spinal cord compression

can lead to serious deficits of bowl and bladder
can be the first identifier of cancer- thought to be lower back pain

10

signs and symptoms of SCC

-pain is worse with movement , cough, having a bowel movement, neck flexion
-pain worsens over days-weeks
urinary retention- early sign
loss of bowel continence- late sign

11

assessment of SCC

pain assessment
physical w palpitation and percussion of spine
sensory assessment
mri
prompt trx can lessen deficits

12

brain mets s/s

h/a, blurred vision, n/v, ataxia, dysphagia, personality changes, seizures

13

trx of brain mets

corticosteriods
anticonvulsants
whole brain radiation
surgical resection

14

hypercalcemia s/s

altered LOC, difficulty concentrating, confusion, personality changes, hallucinations, psychosis, fatigue, lethargy, muscle weakness, pathologic fracture, anorexia, nausea, decreased gastric emptying, abdominal pain, polyuria, lack of intervention may lead to renal failure coma or cardiac arrest

15

tumor lysis syndrome

refers to rapid breakdown of the intracellular electrolyte
may occur spontaneously or rapidly in proliferating tumors after chemo

16

spontaneous lysis

occurs before cancer treatment, hyperkalemia, hyperphosphatemia, hypocalcemia present at time of diagnosis

17

medical and nursing trx of tumor lysis syndrome

identify pt at risk, correct abnormalities, give allopurinol to prevent uric acid crystals, ad NaHco3 to IV fluid, avoid IV potassium bc of potential hyperkalemia, kayexalate, monitor electrolyte, treat hypocalcemia with IV calcium gluconate, hemodialysis if not responding to trx

18

risk factors for tumor lysis syndrome

pretreatment elevation of uric acid and LDH, renal insufficiency/failure, dehydration

19

DIC

hyper coagulation or no coagulation, little clots can form in the organ capillaries or there is uncontrollable bleeding

20

treatment of DIC

underlying conditions and infection, sepsis, volume depletion, labs and fibrogen, hypoxemia, if pt has reoccurent fibrolytic events, IV heparin, LMW heparin, unit of PRBC, FFP, replaces clotting factors

21

nursing management of DIC

bleeding, petecheai, ecchmyosis, purpura, pallor, frank blood oozing, observe mouth and mucus membranes, ascultate lungs for crackles, wheezes, stridor, tachycardia, hypotension, changes in peripherial pulses, i/o, periphrial edema, palpate abdomen, measure girth daily, observe for change in loc, irriability