oncologic emergencies Flashcards
1
Q
disseminated intravascular coagulation (DIC)
A
- Sx occur quickly
- change in patient’s mental status w/confusion & lethargy
- petechiae present as well as some discoloration of skin over areas of bleeding
- breath sounds decreased & weak
- heart sounds may become irregular
- BP may decrease
- may be obvious bleeding from a specific site or all orifices
2
Q
syndrome of inappropriate antidiuretic homone (SIADH)
A
- a condition in which antidiuretic hormone (ADH) is secreted in frequency & amounts that are not necessary
- ADH is normally secreted from the posterior pituitary gland, but it can also come from tissue elsewhere in the body
- ADH functions to cause water to be reabsorbed instead of excreted through the kidneys
- the body normally regulates the amount of water reabsorbed by the renal tubules based on fluid concentrations within the body
3
Q
SIADH physical exam
A
- signs of confusion or even belligerent
- weight should be regularly monitored to assess for any additional fluid retention & resultant weight gain
- check patient frequently for changes in mental status including delirium
- patient may need to be closely observed for any seizure activity is Na levels are diluted to very low levels
4
Q
sepsis
A
- an infection that is spread throughout the body
- usually caused by a bacterial infection, but it can also be caused by viruses & other types of organisms
5
Q
sepsis physical exam
A
- elevated body temp
- changes in HR & RR
- skin exam to check for possible source of infection from IV line or other break in skin
- listen to heart & lungs to assess for any changes
- listen & palpate abdomen for pain or changes
- assess patient for any changes in mental status, though usually present later in the infection
6
Q
septic shock
A
- systemic response to overwhelming infection w/primarily the patient’s own endogenous flora
- endotoxin is released w/the patient experiencing release of histamine, bradykinin, increased capillary permeability, & a decrease in circulating blood volume w/a decrease in tissue perfusion
7
Q
third space syndrome (TSS)
A
- the shift in fluid from the vascular to the interstitial space d/t lowered plasma proteins, increased capillary permeability, or lymphatic blockage from trauma, inflammation, or disease
- typically seen in patients who have undergone major surgical procedures or who are in septic shock
8
Q
tumor lysis syndrome (TLS)
A
- occurs when tumor cells are killed, as intended, by dome form of cancer tx
- when tumor cell is lysed, its intracellular contents are released into the body
- this can cause potentially fatal abnormalities in electrolyte levels
9
Q
hypercalcemia
A
- most common oncologic emergency w/a fatal outcome, occuring in 10-20% of patients
- rise in serum Ca levels, d/t the production of a parathyroid hormone related peptide (PTHrp), normally undetectable
- this peptide reults in increased Ca levels increasing bone resorption
- in a second category, malignant-associated ________________ accounting for approx. 20% of the cases resulted from metastatic bone sites
10
Q
cardiac tamponade
A
- condition in which fluid builds up around the heart & inhibits the ability of the heart to function properly
- heart is surrounded by two membranes that make up the pericardial sac
- normally a small amount of fluid b/w the two membranes to provide lubrication when the heart is pumping
- w/________________, the space b/w the two membranes fills w/more fluid than normal, causing compression on the heart & decreasing its ability to pump effectively
11
Q
spinal cord compression
A
- a condition in which tumors of the cord or tumors affecting intervertebral discs cause pressure to be placed on the spinal cord
- this can be an emergent situation if there is sudden neurologic dysfunction or progressive neurologic dysfunction
12
Q
superior vena cava syndrome (SVCS)
A
- occurs when pressure is applied to the superior vena cava resulting in decreased blood drainage from the upper body
- this compression can be d/t a tumor or blood clot forming in the area
13
Q
increased intracranial pressure (ICP)
A
- a condition in which the brain, the blood supply to the brain, or the cerebrospinal fluid (CSF) that is in & around the brain occupies more room than normal
- this causes an inrease in pressure because the skull is not able to expand to accomodate this increase in volume
14
Q
paraneoplastic opsoclonus myoclonus
A
- characterized by flicks of the eyes in association w/jerky limb movements
- this disorder can be caused by a number of disturbances, including malignant neuroblastoma in children & SCLC & other tumors in adults
- can lead to permanent cognitive problems
15
Q
bowel obstruction
A
- mechanical obstruction of the passage of intestinal contents because of constriction or occlusion of the lumen or lack of muscular contractions (paralytic ileus)
- may occur w/hematological malignancies, such as leukemia & intraabdominal tumors
- some patients receiving vinca alkaloids may develop severe autonomic neuropathy that can result in acute intestinal obstruction
