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Oncological emergencies and cancer medsMedical-Surgical Nursing-7th edition

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Question Answer
Facial edema, periorbital edema, head/neck/chest vein distention, headache, seizures and/or a mediastinal mass are signs and symptoms of what oncologic emergency?
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Superior vena cava syndrome
3rd space syndrome involves a shifting of fluid from the _______ space to the _______ space.
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vascular to the interstitial
What cancers are associated with metastatic hypercalcemia?
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Lung, breast, kidney, colon, ovarian, and thyroid. *PTH - like: lung, head, neck, cervical, esophageal, lymphoma, leukemia.
What are signs and symptoms of a carotid artery rupture?
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Oozing or spurting of blood.
A Hgb of _______ or higher indicates adequate O2 delivery.
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9
How is tumor lysis syndrome treated?
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Hydration therapy and allopurinol.
How is spinal cord compression treated?
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Radiation therapy, prompt initiation of corticosteroids, and/or possible surgical decompressive laminectomy.
What are the 4 hallmark symptoms of tumor lysis syndrome?
Show Answer
Hyperuricemia, hyperphosphatemia, hyperkalemia, and hypocalcemia. Occurs in 24-48 hours after beginning chemo.
What are 2 important nursing interventions for a patient with spinal cord compression?
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Activity limitations and pain management.
How is SIADH treated?
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Treat the malignancy, fluid restriction, and if severe, IV admin. of 3% sodium chloride solution.
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Outpatients at risk for neutropenia should call the Dr. with a temperature of _______ or up.
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100.5/38 degrees C.
What 2 factors can exacerbate hypercalcemia in cancer patients?
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Immobility and dehydration.
How is superior vena cava syndrome treated?
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Radiation (1st line of treatment) and possibly chemo.
How is increased Ca+ treated?
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Loop diuretics (Lasix), increase fluids (3,000-4,000 mL/day), synthetic calcitonin, weight-bearing exercise, Plicamycin (decrease bone resorption), Aredia (lower osteoclast activity), and Gallium nitrate (risky).
How is a carotid artery rupture treated?
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Apply pressure to the site, IV fluid and blood products, and surgical ligation above and below the rupture and reduction of the tumor.
What is the difference between Filgrastim and Pegfilgrastim?
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Pegfilgrastim has an extra polyehtylene glycol added to make the molecule bigger and slow elimination. Filgrastim: Daily injection for 2 weeks. Pegfilgrastim: I dose per chemo cycle.
Sargramostim (Leukine) is a GM-CSF that increases the number of _______ and accelerates _______.
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macrophages; growth and development of bone marrow (thus increasing blood cell activity)
_______ symptoms during or immediately following the administration of GM-CSFs like Leukine (sargramostim) should be given special attention.
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Respiratory (*If dyspnea occurs, reduce infusion by 1/2 or discontinue)
GM-CSF should not be administered with _______ before or after chemo or within _______ before or after radiation.
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24 hours before/after chemo; 12 hours before/after radiation
A _______ should be done biweekly for patients on Neumega, Filgrastim and Sargramostim.
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CBC
_______ along the vein in which 5-FU is administered is a possible side effect of the drug.
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Hyperpigmentation
  
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