neoplastic 4

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  1. Oncologic emergencies
    • obstructive emergencies
    • - superior vena cava syndrome
    • - spinal cord compression
    • metabolic emergencies
    • - tumor lysis syndrome
    • - siadh
    • - hypercalcemia
    • Infection
  2. Obstructive emergencies
    SVC syndrome
    • edema face, arms, upper chest
    • JVD
    • H/A
    • seizures
    • symptomatic, RT, treatment of primary tumor
    • may radiation therapt
    • - diurectics, steriods
    • mass sitting on SVC
    • usually 3 yrs is the max- killing
  3. obstructive emergencies
    spinal cord compression
    • neurological emergency
    • compression of spinal cord and/or vascular supply by tumor in epidural spaces
    • s/s
    • intense, localized persistant back pain
    • motor weakness
    • bowel/bladder changes
    • tx: radiation Tx, steriods, surgery (possible)
    • hx of cancer, new onset back pain- red flag notify MD
  4. metabolic emergencies
    • Tumor lysis syndrome
    • - undergoing chemo- underline cause
    • - usually occurs within the first 48 hr of chemo could last for week
    • - monitor them for this
    • - large/rapid amount of K and phosphate (PO4) and nucliec acid released from destroy tumor cells (chemo breakdown cells)
    • - electrolyte imbalance and kidney failure
    • - classic features: ***hyperurecemia, hyperphosatemia, hyperkalecemia, hypocalcemia (invert relationship with postassuim and calcium- so if k is high Ca will be low)
    • weakness, N/D, flaccid paralysis, ECG changes, muscle cramps, oliguria, hypotension- poor perfusion check renal failure, edema, change in mental status
    • tx- is hydration IV fluids, and allopurinol
    • once protein is broken down it releases uric acid
  5. Metabolic emergenice
    • syndrome of inapproriate (increase) ADH,
    • to much ADH holds on to H2O and Na
    • overproduction of ADH
    • - caused by tumor manufacture, store and release ADH
    • s/s
    • fluid retention, hypoatremia,
    • weight gain, n/v, weakness, seizure
    • tx- underlying cause
  6. Hypercalcemia
    • metastatic of bone and/or tumor releases PTH like substance
    • bone breaks down and releases ca to the blood
    • too much ca in blood
    • PTH incre ca level
    • s/s
    • Moans- fatigue, muscles weakness ekg changes
    • groans: renal stones, GI issues
    • bone: loss Ca in bone- incre fraction and osteomalacia
    • tx underlying disease
    • tumor tends to be usually comes from lung cancer
  7. cancer pain
    • too often undertreated
    • from the cancer of its treatments
    • careful assessment
    • location, intensity, quality, pattern perciptating/alleviating factors
    • WHO ladder
    • NAIDs, opiods, adjuvant meds
  8. Cancer pain cont
    • scheduled doses with PRN for breakthrough
    • relaxation therapy
    • guided imagery
    • positioning
    • TENS
  9. Complementary and alternative medcine
    • read links
    • CAM
    • not considered part of conventional medical treament
    • scientific evaluation
    • - national center for complementary and alternative medicine
    • healthcare team should be discuss
  10. CAM
    • complementary- together with conventional medicine
    • alternative- in place of conventional medicine
    • prayer and spiritual practice
    • relaxation
    • faith and spiritual healing
    • nutritional supplements and vitamins
  11. CAM 2
    questions pt should ask health care providers
    • what benefits can be expected from this therapy?
    • what are the risk associated with this therapy?
    • do the known benefits outweigh the risk?
  12. CAM 3
    • what side effects and be expected
    • will the therapy interfer with conventional therapy
    • is the treatment apart of a clinical trial if so who is sponsoring the trial
    • will the therapy be covered by health insurance
  13. Psychological supportq
    • patient and family
    • open communication with health care team support system
    • realistic positive attitudes
    • complete truthful answers
    • offer self
  14. psychological support 2
    • spirituality and religion
    • support groups
    • - breast ca- reach to recovery, Y me, can surmount, encore andmore
    • - acs and NCL
    • hospice
Card Set:
neoplastic 4
2015-11-07 20:14:57

it sucks
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