Oncologic Emergenices
Nursing intervention is to keep down fever, neutropenic precautions, monitor vital signs.
Sepsis
A 30-year-old male is found unconscious after an explosion. He is not breathing. When you open his airway, he begins shallow respirations at 8/min.
Red (immediate)
ALL
AML
What does the C in CLL and CML stand for?
Acute lymphatic Leukemia
Acute Myeloid Leukemia
Chronic
Chronic Lymphatic leukemia
Chronic Myeloid Leukemia
Increased hgb, lymphocytes, platelets
use of aspirin, anticoagulants, increase PO fluid intake, prevent infection/bleeding/clotting, smoking cessation
Polycythemia Vera (PV) hyperviscosity of blood
new stem cells attack existing cells in the body
graph vs. host disease
Obstruction caused by tumor, thrombosis, infection, etc. S/SX: swelling of the face/neck, SOB, cough, venous distention, ruddy complexion
A 7-year-old child walking around crying with minor abrasions to the arms and face. Breathing 20/min, cap refill <2 seconds.
Green (minor) can walk
Signs/Symptoms of leukemia
Fatigue/Weakness, bleeding and bruising easily, petechiae, infections (Examples), fever,
ASYMPTOMIC (early)
ABCDE of tramua
Airway, breathing, circulation, disability, and exposure
multiple myeloma diagnosis uses this acronym
CRAB (c=hyperCalciumia, r=Renal insuffiency -creatinine, a= Anemia -look @CBC, b=Bone lesions -x-ray)
characterized by pain, weakness, numbness/tingling, bowel/bladder dysfunction
treatment: bed rest, pain control, good skin care, brace, sensory control, elimination control
Spinal Cord Compression
A 25-year-old male with chest wound. Respiratory rate 35/min, labored breathing, cap refill >3 seconds, altered mental status.
Red (immediate)
Diagnostics of Leukemia
low hemoglobin, platelets, WBC (can be extremely high) BLAST cells... whats a good way to remember blasts cells as an indicator of leukemia...?
This red blood cell disorder has decreased RBC, and decrease HGB. Patients HR and RR increases, is feeling fatigued, weak, has brittle nails, and has lack of coordination and LOC
Anemia
this medication is used for neutropenia in relation to decrease thrombocytes
Filgrastim and pegfilgratism
symptoms: nausea, fatigue, constipation
maintain fluid intake, and salt intake, weight bearing activities, control underlying disease, reverse dehydration
MONITOR LABS
Hypercalcemia
A 70-year-old with 95% body surface area burns, pulseless and apneic after airway repositioning.
Black (expectant/ deceased)
What are two types of Lymphoma? How can you differentiate the two?
Hodgkin (reed-sternberg cells) vs. Non-Hodgkin
What is a comparative way to remember anemia? Think about example in class.
You do not have enough train cars to transport all the blood cells so you need the train cars to go faster.
Nursing diagnosis: Risk for infection...
Whatcha gonna do about it?
handwashing
avoid; soil, plants, little boxes, animals, crowds
wash dishes in HOT water,
private rooms, hepa filters, ice machines, construction,
limit caregivers, montior VS
increase uric acid, potassium and phosporus, decrease in calcium. seizures and arrhythmia
intracellular contents of dying cancer are released into the bloodstream
Tumor Lysis Syndrome (TLS)
A 45-year-old female with an open femur fracture. She is alert, breathing 24/min, cap refill 3 seconds, radial pulse weak but present.
Yellow (Delayed)
What process of stem cell transplant is this?
1. Identify a donor
2. Mobilization of donor (conditioning of patient)
3. Harvest cells
4. Supportive Care
5. Engraftment --> continued prevention (monitor for rejection)
where does this stem cell transplant come from?
Allogeneric AKA "allo"
can be sibling or a matched unrelated donor
The first step when a transfusion reaction happens.
STOP the blood!
then stay with patient, change all tubing, monitor closely, send all tubing/blood with blood and urine samples to the lab.
Nursing Diagnosis: Risk for bleeding...
Nursing Interventions
Use electric razor, soft oral care/no flossing or dental work, No ASA or NSAIDS, no contact sports, apply ice, no invasive procedures, bed assist, "Let it fall out of you", humidified O2