adult 1: oncological emergencies

Question 1

What is spinal cord compression in oncology?

Answer 1

Spinal cord compression occurs when cancer spreads to the epidural space of the spinal cord.

Question 2

What are the signs and symptoms of spinal cord compression?

Answer 2

Intense localized persistent back pain, motor weakness, paresthesias, autonomic dysfunction (e.g., bowel/bladder function changes).

Question 3

What are the nursing interventions for spinal cord compression?

Answer 3

Radiation, corticosteroids, surgical decompressive laminectomy, activity limitations, pain management, adapt ADLs, help with ambulation.

Question 4

What is superior vena cava syndrome?

Answer 4

Superior vena cava syndrome is the obstruction of the superior vena cava by a tumor or thrombosis.

Question 5

What are the signs and symptoms of superior vena cava syndrome?

Answer 5

Facial/periorbital edema, jugular venous distension (JVD), headache, seizures, mediastinal mass on chest X-ray.

Question 6

What are the nursing interventions for superior vena cava syndrome?

Answer 6

Radiation to the site of obstruction, chemotherapy for tumors.

Question 7

What is third space syndrome?

Answer 7

Third space syndrome is a shift of fluid from the vascular space to the interstitial space.

Question 8

What are the signs and symptoms of third space syndrome?

Answer 8

Hypovolemic shock, with low blood pressure (BP), high heart rate (HR), and low urine output.

Question 9

What are the nursing interventions for third space syndrome?

Answer 9

Fluid, electrolyte, and plasma protein replacement; watch for hypervolemia (high BP, weight gain, dyspnea).

Question 10

What is hypercalcemia in oncology?

Answer 10

Hypercalcemia is the condition of having excess serum calcium.

Question 11

What is the serum calcium level in hypercalcemia?

Answer 11

Serum calcium >12.

Question 12

What are the symptoms of hypercalcemia?

Answer 12

Apathy, depression, fatigue, muscle weakness, ECG changes/dysrhythmias.

Question 13

What other symptoms are associated with hypercalcemia?

Answer 13

Polyuria/nocturia, anorexia, N/V, renal failure if chronically elevated.

Question 14

What are the nursing interventions for hypercalcemia?

Answer 14

Hydration (3L/day), loop diuretics, infusion of bisphosphonates.

Question 15

What are additional nursing interventions for hypercalcemia?

Answer 15

RANKL inhibitor injection, Denosumab (Xgeva).

Question 16

What is SIADH in oncology?

Answer 16

SIADH is when tumor cells produce abnormal or sustained production of ADH, leading to water retention.

Question 17

What are the signs and symptoms of SIADH?

Answer 17

Water retention, hyponatremia, weight gain without edema.

Question 18

What other symptoms are associated with SIADH?

Answer 18

Weakness, anorexia, N/V, personality changes, seizures.

Question 19

What are the severe symptoms of SIADH?

Answer 19

Oliguria, decreased reflexes, coma.

Question 20

What are the nursing interventions for SIADH?

Answer 20

Correct sodium-water imbalance with fluid restriction, oral salt tablets.

Question 21

What are additional nursing interventions for SIADH?

Answer 21

NS or 3% sodium chloride for severe cases, furosemide in early stages, monitor sodium levels.

Question 22

What is the correct approach to SIADH treatment?

Answer 22

Correct SIADH slowly to prevent seizures or death.

Question 23

What is tumor lysis syndrome?

Answer 23

Tumor lysis syndrome is the rapid release of intracellular components from dying tumor cells that are metabolized into uric acid by the liver.

Question 24

What electrolyte imbalances are seen in tumor lysis syndrome?

Answer 24

Hyperuricemia, hyperphosphatemia, hyperkalemia, hypocalcemia.

Question 25

What are the symptoms of tumor lysis syndrome?

Answer 25

Weakness, muscle cramps, N/V/D, dysrhythmias, seizures, syncope.

Question 26

What complication can tumor lysis syndrome cause?

Answer 26

Tumor lysis syndrome can cause acute kidney injury (AKI).

Question 27

What are the nursing interventions for tumor lysis syndrome?

Answer 27

Identify patients at risk (radiation/chemotherapy).

Question 28

What should be monitored in patients with tumor lysis syndrome?

Answer 28

Monitor electrolyte values.

Question 29

How should hydration be managed in tumor lysis syndrome?

Answer 29

Maintain high urine output with hydration therapy.

Question 30

What is used to decrease uric acid in tumor lysis syndrome?

Answer 30

Allopurinol is used to decrease uric acid concentration.

Question 31

What safety precautions should be taken in tumor lysis syndrome?

Answer 31

Implement safety precautions (seizures, fall prevention).

Question 32

What is cardiac tamponade?

Answer 32

Cardiac tamponade is the accumulation of fluid in the pericardium.

Question 33

What are the symptoms of cardiac tamponade?

Answer 33

Heavy breathing over chest, dyspnea, high HR, low BP, dysphagia, hiccups, hoarseness, N/V, excessive sweating, decreased LOC, distant/muted heart sounds, extreme anxiety.

Question 34

What is Beck's triad?

Answer 34

Beck's triad consists of hypotension, JVD, and muffled heart sounds.

Question 35

What are the nursing interventions for cardiac tamponade?

Answer 35

Decrease fluid around the heart with surgery (pericardial window or indwelling pericardial catheter).

Question 36

What are additional nursing interventions for cardiac tamponade?

Answer 36

Administer O2 therapy, hydration, and vasopressors (to raise BP).

Question 37

What is carotid artery rupture in oncology?

Answer 37

Carotid artery rupture occurs when a tumor invades the arterial wall or after surgery/radiation therapy.

Question 38

What are the symptoms of carotid artery rupture?

Answer 38

Bleeding, either minor oozing or severe spurting.

Question 39

What are the nursing interventions for carotid artery rupture?

Answer 39

Administer IV fluids and blood products.

Question 40

What additional nursing interventions are needed for carotid artery rupture?

Answer 40

Surgery to ligate the carotid artery above and below the rupture and reduction of the local tumor.