COCN Oncologic Emergencies Flashcards

When preparing a neutropenic fever patient for empiric antibiotic therapy, what is the target time from fever detection to first antibiotic dose?

Answer: Within 1 hour

Current oncology guidelines recommend administering empiric broad-spectrum antibiotics within 60 minutes of fever identification in neutropenic patients.

Which imaging modality is preferred for emergency evaluation of suspected malignant spinal cord compression?

Answer: MRI of the entire spine

MRI of the entire spine is the gold standard for identifying the level and extent of epidural cord compression.

A patient with SCLC is admitted with sudden agitation, confusion, and a serum sodium of 118 mEq/L. The initial treatment is:

Answer: Fluid restriction with careful slow sodium correction

Fluid restriction is first-line for SIADH; sodium must be corrected slowly (≤8–10 mEq/L/day) to prevent osmotic demyelination syndrome.

Which sign is associated with hypocalcemia seen in tumor lysis syndrome when a blood pressure cuff causes carpal spasm?

Answer: Trousseau sign

Trousseau sign is carpal spasm elicited by inflating a BP cuff above systolic pressure, indicating hypocalcemia-induced neuromuscular irritability.

In the management of DIC in an oncology patient, which blood product replaces clotting factors V and VIII most effectively?

Answer: Fresh frozen plasma (FFP)

FFP contains all clotting factors and is the primary product for replacing factor deficiencies in DIC.

A patient with known breast cancer develops sudden shortness of breath, tachycardia, pleuritic chest pain, and hypoxia. The priority nursing action is:

Answer: Notify the physician immediately and prepare for diagnostic workup for pulmonary embolism

Cancer patients have significantly elevated VTE risk; these symptoms are classic for pulmonary embolism requiring urgent evaluation.