oncological emergencies Flashcards

(21 cards)

1
Q

pericardial effusion

A

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

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2
Q

signs and symptoms of pericardial effusion

A

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

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3
Q

treatment of cardiac tamponade

A

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

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4
Q

complications associated with pericardectomy

A
anesthesia risk 
dysrythmia 
bleeding 
infection 
hemothorax
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5
Q

sclerotherapy

A

injected into the pericardium to “harden” prevents reaccumilation of fluid

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6
Q

complications of sclerotherapy

A

localized pain, fever, PVCs, pericarditis, myelosuppression

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7
Q

superior vena cava syndrome

A

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

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8
Q

s/s of superior vena cava syndrome

A

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

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9
Q

spinal cord compression

A

can lead to serious deficits of bowl and bladder

can be the first identifier of cancer- thought to be lower back pain

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10
Q

signs and symptoms of SCC

A

-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

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11
Q

assessment of SCC

A
pain assessment
physical w palpitation and percussion of spine 
sensory assessment 
mri 
prompt trx can lessen deficits
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12
Q

brain mets s/s

A

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

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13
Q

trx of brain mets

A

corticosteriods
anticonvulsants
whole brain radiation
surgical resection

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14
Q

hypercalcemia s/s

A

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

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15
Q

tumor lysis syndrome

A

refers to rapid breakdown of the intracellular electrolyte

may occur spontaneously or rapidly in proliferating tumors after chemo

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16
Q

spontaneous lysis

A

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

17
Q

medical and nursing trx of tumor lysis syndrome

A

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
Q

risk factors for tumor lysis syndrome

A

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

19
Q

DIC

A

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

20
Q

treatment of DIC

A

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
Q

nursing management of DIC

A

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