Unit 10 Chapter 20 Oncologic Emergencies Flashcards
List 3 Oncologic emergencies
- Superior Vena Cava Syndrome-
- Tumor Lysis Syndrome-
- DIC-
- Syndrome of Inappropriate antidiuretic
Hormone- - Spinal Cord Compression-
- Hypercalcemia-
- Sepsis
What is DIC -Disseminated Intravascular
Coagulation
Disseminated intravascular coagulation (DIC) is a problem with the blood- clo ing process. DIC is triggered by many severe illnesses, including cancer. In patients with cancer DIC often is caused by sepsis from a variety of organisms (bacterial, fungal, viral, or parasitic).
Prevention of DIC
STRICT ASESPSIS TECHNIQUE
Emergent s/s of DIC that can lead to fatal hemmorrhage?
This widespread clott ing depletes circulating clo tting factors and platelets.
As this happens, extensive bleeding occurs.
Bleeding from many sites is the most common problem and ranges from oozing to fatal hemorrhage.
What is the tx for DIC
When sepsis is present and DIC is likely, management focuses on reducing the infection and halting the DIC process.
-IV antibiotic therapy is initiated. During the early phase of DIC, anticoagulants (especially heparin) are given to limit clotting and prevent the rapid consumption of circulating clotting factors.
-When DIC has progressed and hemorrhage is the primary problem, clo tting factors are given. .
What is SIADH-Syndrome of Inappropriate Antidiuretic Hormone
fluid retention
What is a common cause of SIADH?
A. Cancer
B. Hemmrohage
C. Infection
D. Respiratory Depression
A. Cancer
S/s of Hyponatreima
Mild symptoms include weakness, muscle cramps, loss of appetite, and fatigue. With greater fluid retention and decreased sodium levels, weight gain, nervous system changes, personality changes, confusion, and extreme muscle weakness occur. As the sodium level drops toward 110 mEq/L (mmol/L), seizures, coma, and death may follow depending on how rapidly hyponatremia occurs.
Should a client with SIADH be on seizure precaution?
A. YES
b.NO
A. YES
due to hyponatremia and electrolye dialation
s/s of SIADH
Mild symptoms include weakness, muscle cramps, loss of appetite, and fatigue. With greater fluid retention and decreased sodium levels, weight gain, nervous system changes, personality changes, confusion, and extreme muscle weakness occur.
As the sodium level drops toward 110 mEq/L (mmol/L),
seizures, coma, and death may follow depending on how rapidly hyponatremia occurs.
Critical Rescue SIADH
Monitor patients at least every 2 hours to recognize signs and symptoms of increasing fluid overload (bounding pulse, increasing neck vein distention [jugular venous distention (JVD)], presence of crackles in lungs, increasing peripheral edema, or reduced urine output) because pulmonary edema can occur very quickly and lead to death. When symptoms indicate that the fluid overload from SIADH either is not responding to therapy or is becoming worse, respond by notifying the primary health care provider immediately.
What is the adverse effect of Mannitol
A. Hyperthermia
B. Altered level of consciousness
C. Pulmonary edema
D. Aortic Stenosis
C. Pulmonary edema
Managment of SIADH
Management includes fluid restriction, increased sodium intake, and drug therapy. Immediate cancer treatment with radiation or chemotherapy may cause enough tumor regression that ADH production returns to normal.
What is Spinal Cord Compression
Spinal cord compression (SCC) is an oncologic emergency that requires immediate intervention to relieve pain and prevent permanent neurologic damage.
Damage from SCC occurs either when a tumor directly enters the spinal cord or spinal column or when the vertebrae collapse from tumor degradation of the bone.
s/s of Spinal Cord Compression
-Back pain
-weakness,
-loss of sensation,
-urinary retention,
-constipation.
-decreased deep tendon reflexes
-reduced pinprick and vibratory sensations
