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Oncological Emergencies

Adult Nursing NCLEX Review Cancer, Chemotherapy, Radiation Therapy, and Oncological Emergencies Oncological Emergencies

Spinal Cord Compression

Tumor enters spinal cord and vertebral column collapses

Symptoms

Assess neuro status

Early recognition is the key to managing this complication.

Treatment

Sepsis and Diseminated Intravascular Coagulopathy

Bacterial enters blood leading to sepsis and DIC. DIC is extensive abnormal clotting. Clotting factors are used up leading to bleeding, organ dysfunction and death. Best treatment is prevention, early identification, aseptic technique, neutropenic precautions.

Syndrome of Inappropriate AntiDiuretic Hormone

Weight gain (water retention), personality changes, confusion, seizures, coma, and death due to hyponatremia.
treatment: Restrict fluids, diuretics, daily weights

Hypercalcemia

Symptoms: Fatigue, anorexia, nausea, vomting, constipation, ileus, dehydration, EKG changes, and loss of DTRs

Treatment: Hydration, Calcitonin & Steroids

Superior Vena Cava Syndrome

Tumor Lysis Syndrome

Tumor cells are destroyed releasing potassium, phosphorus, and uric acid into the blood stream. Monitor kidney function. Hydrate, Hydrate, and administer Allopurinol

Pericardial Effusion & Cardiac Tamponade

Do not administer aspirin or anticoagulants
Give anti-inflammatories if it is just a pericardial effusion (will ⇓ pain).
Cardiac tamponade is a medical emergency.
Assess: listen for pericardial rub!
Pulsus paradoxus or paradoxical pulse (BP drops with inhalation): Think! When you take a deep breath you are compressing the heart more so it makes sense that BP is lower on inspiration. When you breathe out, you are releasing tension on the heart so makes sense that BP is higher. A change of > 10 mm Hg is significant.