Cancer Complications: Tumor Lysis Syndrome Flashcards
What happens with this?
Large amounts of tumor cells rapidly killed by chemo, then large amounts of potassium, phosphate, and uric acid are released into circulation
What is released into circulation when the chemo is killing the tumor cells?
Potassium
Phosphate
Uric acid
High levels of uric acid= ?
Damage to kidneys
When would TLS likly occur?
After FIRST cycle of chemo
S/S
Weight loss or gain?
Gain
S/S
Cachexia or edema?
Edema
S/S
Diarrhea or constipation?
Diarreha
S/S
Energy or lethargy?
Lethargy
S/S
Muscle ___
Cramps
S/S
What abdominal issues?
NV
S/S
Weakness or strenght?
Weaknes
S/S
How is UO?
Oliguria
S/S
T/F: Seizures
True
S/S
What positive signs?
Chovstek
Trosseau
What is chovstek sign?
Twitching of facial muscle in response to tapping over the area of facial nerve
What is trousseau sign?
Carpopedal spasm caused by inflating the BP cuff to a level above systolic pressure for 3 min
S/S
Hypo or hyperactive DTR?
Hyperactive
S/S
What is heart like?
Dysrhythmias–watch ECG
Management?
Education
Prevention
What should oral intake be–decreased or increased?
Increased!!!
Prevention
Drink more—how much?
3000-5000
Prevention
Consistent schedule of what?
Fluid intake
*may need IV saline if can’t drink enough
Prevention
What hydration?
Isotonic saline
What diet restrictions?
Low phosphate and K+ in foods
Treatment?
Electrolyte imbalance tx
What safety precautions?
Seizure precautions
T/F: May need dialysis
T
What drugs?
Diuretics
Uric acid excretion
Vasopressor
Reduce K+ levels
What diuretic and why?
Osmotic (mannitol) for treating edema
What uric acid excretion drug?
Allopurinol
What vasopressor?
Dopamine
How to reduce K+ levels?
Sodium polystyrene sulfonate
IV insulin and IV D50
