COCN Oncologic Emergencies Flashcards

The first-line pharmacologic treatment for malignant hypercalcemia, after IV hydration, is:

Answer: IV zoledronic acid or pamidronate

IV bisphosphonates (zoledronic acid or pamidronate) are the drugs of choice for sustained lowering of serum calcium in malignancy.

Which medication is the cornerstone of initial treatment for malignant spinal cord compression?

Answer: High-dose corticosteroids (dexamethasone)

High-dose dexamethasone reduces perilesional edema, preserving neurologic function while definitive treatment is arranged.

A patient develops syndrome of inappropriate antidiuretic hormone (SIADH) secondary to small cell lung cancer. The primary nursing concern is:

Answer: Hyponatremia and fluid restriction

SIADH causes dilutional hyponatremia; fluid restriction is the primary treatment to reduce water retention.

Which assessment finding indicates worsening cardiac tamponade requiring emergency pericardiocentesis?

Answer: Increasing pulsus paradoxus (>10 mmHg) with hemodynamic instability

Progressive pulsus paradoxus with hemodynamic compromise indicates critical tamponade physiology requiring immediate drainage.

Neutropenic fever in an oncology patient is defined as a single temperature above 38.3°C (101°F) with an ANC below:

Answer: 500/mm³

Neutropenic fever requires ANC <500/mm³ (or <1000/mm³ expected to fall), combined with fever, as per IDSA guidelines.

A patient with lymphoma develops rapid onset of elevated serum potassium, elevated phosphate, elevated uric acid, and decreased calcium. The nurse recognizes this as:

Answer: Tumor lysis syndrome (TLS)

The metabolic tetrad of hyperkalemia, hyperphosphatemia, hyperuricemia, and hypocalcemia is diagnostic of tumor lysis syndrome.