Oncology Emergencies
You have a patient diagnosed with advanced metastatic prostate cancer. This patient complains of constipation and pain in their pelvic area? What and why is this patient experiencing these symptoms?
What is hypercalcemia caused by bone metastasis.
Your patient has a platelet count of 50,000 what complication of chemotherapy is your patient likely experiencing?
What is thrombocytopenia?
You have a patient with a potassium level of 6.5 and a uric acid level of 10.3.
What is this patient likely experiencing?
What is tumor lysis syndrome?
What term describes chemotherapies effect on cells (both healthy and malignant)?
What is education you can provide a patient who is experiencing taste disturbances?
What is: avoid favorite foods; use plastic utensils instead of metal; avoid red meats!
Your patient is experiencing Superior Vena Cava Syndrome. How do you prevent and or treat this condition?
What is extreme hydration!
Want the patient to drink at least 3-5 liters of water prior to and after chemotherapy administration.
Your patient has gone through multiple rounds of chemotherapy and is experiencing loss of their hair. What is this patient experiencing?
What is alopecia?
You have a patient recieving chemotherapy for breast cancer. This patient is experiencing difficulty concentrating and remembering details.
What is this patient likely experiencing?
What is "Chemo brain"?
What is the term for chemotherapy that is administered prior to surgery; typically used for debulking or shrinking the tumor?
What is neoadjuvant chemotherapy?
What is the most common medication to be administered to a patient for nausea/vomiting?
What is Ondansetron (Zofran)?
Your patient is experiencing severe lower back pain and paresthesia. What is likely occurring?
(Administer glucocorticoids and radiation!)
Your patient is experiencing tingling and numbness in both their lower extremities. The patient's provider diagnoses them with chemotherapy-induced peripheral neuropathy. As a nurse what is a CRUCIAL teaching that needs to be provided to the patient?
What is: daily feet inspections, checking temperature before showers/baths, and or proper shoe fitting?
You are a newly graduated nurse who just completed led their oncology training (you can administer IV chemotherapy woohoo!).
You begin to administer an IV chemotherapy agent, the patient begins to report pain, and you notice redness around the IV site? What do you do?
Additionally, assess IV site patency every few minutes while administering the medication.
Name three aspects or factors that effect the dosage for chemotherapy?
What is: the patient's weight and height, the cancer's type and if the cancer has metastasized.
Your patient is experiencing pancytopenia, what three labs are likely diminshed?
What is red blood cell count, neutrophil (WBC count), and platelet count?
You just received the labs for your one patient, and they have a sodium level of 125 mEq/L. You place the patient on a high-sodium diet and fluid restriction.
What is likely causing this low sodium level?
What is Syndrome of Inappropriate Anti-Diuretic Hormone (SIADH).
(Dilutional-hyponatremia)
Your patient is experiencing nausea prior to their first chemotherapy treatment appointment?
What medication should the patient be administered to help with their anticipatory nausea?
What is Ativan (lorazepam)?
Administered: IV push or oral!
Your patient is experiencing pain in their mouth that is impeding their want to eat food. Upon inspection you notice sores on the patient mouth.
What is this patient likely experiencing and how should you help this patient?
What is mucositis?
What is: administer magic swizzle 30 minutes prior to the patient's mealtime.
What is double gloved, gowns, and eye protection!
What is the benefit of having patients receive combination chemotherapy?
What is combination chemotherapy "attacks" the cancer cells in different ways in turn making the chemotherapy more effective!
DOUBLE JEOPARDY
Your patient is experiencing sepsis induced by a gram-negative bacterium. What should the nurse look out for?
Gram negative sepsis can lead to DIC (Disseminated Intravascular coagulation syndrome).
Provide reasoning as to why this is an inappropriate gift for this patient?
What is: the flowers may have pesticides that can put the patient at a greater risk of infection!
You have just been given report on the three patients you have. Which patient is the priority and why?
1) Patient with facial edema, and an SpO2 of 93%.
2) Patient with a PLT count of 40K.
3) Breast cancer patient that is experiencing a difficulty concentrating and unaware of the time.
What is the first patient.
Patient 1 is likely experiencing SVCS which can lead to dyspnea and stridor (ABCs).
Patient 2 is a bleeding risk but ABCs take priority.
Patient 3 is likely experiencing "Chemo brain"; needs reoriented but not priority (if vitals are WNL).
Chemotherapy can be administered in many different ways.
Name 5 ways discussed in class on how chemotherapy can be administered?
What is: oral, intrathecal (CSF), intraperitoneal, intravesicular (bladder), topical, intravascular and intra-arterial.
You have a patient that has just entered remission. What is important teaching to provide to these patients?
What is survivorship teaching?
Teach about important of attending follow-up appointments and address physical and psychological needs for these patients!