COCN Oncologic Emergencies Flashcards

Superior vena cava (SVC) syndrome is most commonly caused by which malignancy in the United States?

Answer: Lung cancer and lymphoma

Lung cancer (especially small cell and squamous cell) and lymphoma account for the majority of SVC syndrome cases.

A patient with SVC syndrome presents with facial swelling, plethora, and dyspnea. The priority nursing intervention is:

Answer: Elevate the head of the bed to 45 degrees and administer oxygen

Elevating the head reduces venous pressure in the upper body and supplemental oxygen addresses hypoxia in SVC syndrome.

Spinal cord compression in a cancer patient most commonly presents with which early symptom?

Answer: Back pain that worsens with lying down or Valsalva maneuver

Back pain is the earliest and most common presenting symptom of malignant spinal cord compression, often preceding neurologic deficits.

Which of the following cancers has the highest incidence of hypercalcemia of malignancy?

Answer: Squamous cell cancers and multiple myeloma

Squamous cell cancers (lung, head and neck) and multiple myeloma most frequently cause hypercalcemia through PTHrP or osteolytic mechanisms.

A patient with lung cancer develops pulsus paradoxus, hypotension, and muffled heart sounds. The nurse recognizes this as:

Answer: Cardiac tamponade

Beck's triad (hypotension, muffled heart sounds, distended neck veins) plus pulsus paradoxus is classic for cardiac tamponade.

Disseminated intravascular coagulation (DIC) in oncology patients is most associated with which malignancy?

Answer: Acute promyelocytic leukemia (APL)

APL releases tissue factor from granules in promyelocytes, triggering the coagulation cascade and causing DIC.