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NURS 3512 - Class 7-12 > Week 11 - Oncological Emergencies > Flashcards

Week 11 - Oncological Emergencies Flashcards

1
Q

what are oncological emergencies

A
  • life-threatning events that can occur as a result of cancer or cancer treatment
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2
Q

oncological emergencies can be.. (3)

A
  • obstructive
  • metabolic
  • infiltrative
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3
Q

what are obstructive emergencies caused by

A
  • primarily by tumour obstruction of an organ or blood vessel
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4
Q

what are examples of obstructive emergencies (4)

A
  • SVC syndrome
  • spinal cord compression
  • intestinal obstruction
  • third space syndrome
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5
Q

what is SVC syndrome

A
  • results from obstruction of the SVC by a tumour
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6
Q

what are signs of SVC syndrome (6)

A
  • facial edema
  • periorbital edema
  • distension of neck & chest
  • HA
  • seizures
  • mediastinal mass on CXR
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7
Q

what is treatment for SVC (3)

A
  • radiation therapy to site of obstruction
  • treatment of primary tumour
  • chemo
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8
Q

what is spinal cord compression (SCC)

A
  • neuro emergency caused by the presence of a malignant tumour in the epidural space of the spinal cord
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9
Q

what are signs of SCC (5)

A
  • intense, localized, persistent back pain
  • vertebral tenderness
  • motor weakness & dysfunction
  • sensory parasthesia and loss
  • autonomic dysfunction (ex. change in bowel & bladder function)
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10
Q

what is treatment of SCC (3)

A
  • radiation if slowly progressive neuro deficits
  • surgery is rapidly progressive neuro deficits, or radiologically resistant
  • chemo
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11
Q

what is third space syndrome

A
  • involves a shifting of fluid from the vascular space to the interstitial space d/t extensive surgical procedures, biological therapy, or septic shock
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12
Q

what are signs of third space syndrome (5)

A
  • hypovolemia S&S
  • hypotension
  • low urine output
  • tachycardia
  • low central venous pressure
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13
Q

what is treatment for third space syndrome (3)

A
  • fluids
  • electrolytes
  • plasma protein replacement
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14
Q

what occurs during recovery of 3rd space syndrome (4)

A
  • hypervolemia
  • HTN
  • weight gain
  • SOB
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15
Q

what is treatment for hypervolemia associated w recovery of 3rd space syndrome (2)

A
  • reduction in fluid admin

- fluid balance monitoring

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16
Q

what is intestinal obstruction

A
  • partial or complete obstruction of GI tract by a tumour
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17
Q

what is the treatment for intestinal obstruction (3)

A
  • radiation
  • chemo
  • surgery
18
Q

what are metabolic emergencies

A
  • oncologic emergencies caused by the production of ectopic hormones directly from the tumour or are secondary to cancer treatment
19
Q

what are examples of metabolic emergencies (5)

A
  • SIADH
  • hypercalcemia
  • tumour lysis syndrome
  • septic shock
  • disseminated intravascular coagulation
20
Q

what is SIADH

A
  • abnormal or sustained production of ADH

- cancer cells manufacture, store, and release ADH

21
Q

what are signs of ADH (7)

A
  • weight gain
  • weakness
  • anorexia
  • NV
  • personality changes
  • seziures
  • coma
22
Q

what is treatment for SIADH r/t cancer (2)

A
  • fluid restriction

- hypertonic saline

23
Q

when might hypercalcemia occur r/t cancer

A
  • in the presence of cancer that involves the bone = release of CA into bloodstream
24
Q

what are signs of hypercalcemia (7)

A
  • apathy
  • depression
  • fatigue
  • muscle weakness
  • ECG changes
  • polyuria and nocturia
  • ANV
25
Q

what is treatment of hypercalcemia (3)

A
  • hydration
  • diuretics
  • biphosphate infusion (inhibits action of osteoclasts)
26
Q

what is an example of a bisphosphate

A
  • pamidronate
27
Q

what is tumour lysis syndrome

A

-frequently triggered by chemo
- results from rapid destruction of tumour cells
= electrolyte imbalances and renal failure

28
Q

what are the 4 hallmark signs of tumour lysis syndrome

A
  • hyperuricemia
  • hyperphosphatemia
  • hyperkalemia
  • hypocalcemia
29
Q

what is the treatment of TLS (2)

A
  • increase urine production thru hydration therapy

- decrease uric acid production thru allopurinol

30
Q

what are infiltrative emergencies

A
  • occur when malignant tumours infiltrate major organs secondary to cancer therapy
31
Q

what are 2 examples of infiltrative emergencies

A
  • carotid artery rupture

- cardiac tamponade

32
Q

what does cardiac tamponade occur from (3)

A
  • fluid accumulation in the pericardial sac
  • constriction of the pericardium by tumour
  • secondary to radiation therapy for the chest
33
Q

what is cardiac tamponade

A
  • accumulation of fluid in the pericardial sac = heart pumps ineffeciently
34
Q

what are signs of cardiac tamponade (12)

A
  • heavy feeling over chest
  • SOB
  • tachycardia
  • cough
  • dysphagia
  • hiccups
  • hoarseness
  • NV
  • excessive perspiration
  • decreased LOC
  • distant or muted heart sounds
  • anxiety
35
Q

emergency management of cardiac tamponade is aimed at? (3)

A
  • reduction of fluid around the heart
  • surgical establishment of a pericardial window
  • indwelling pericardial cath
36
Q

what does supportive therapy for cardiac tamponade include (3)

A
  • O2
  • IV hydration
  • vasopressor therapy
37
Q

what does carotid artery rupture result from

A
  • occurs w head and neck cancers

- invasion of the artery wall from tumour or erosion from treatment

38
Q

what can carotid artery rupture manifest as (2)

A
  • ranges from minor oozing

- to spurting of blood

39
Q

in the presence of bursting d/t carotid artery rupture . what should be done

A
  • apply pressure to the site w a finger
40
Q

what is included in treatment of carotid artery rupture (4)

A
  • manual pressure
  • IV fluids
  • blood products
  • surgery
41
Q

what does surgery of carotid artery rupture involve (2)

A
  • ligation of the carotid artery above and below the rupture site
  • reduction of local tumour

NURS 3512 - Class 7-12 (49 decks)

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