OCC Oncology Emergencies & Complications Flashcards

A patient with multiple myeloma develops confusion, polyuria, constipation, and a serum calcium of 13.5 mg/dL. What is the initial treatment priority?

Answer: Begin aggressive IV normal saline hydration to promote calciuresis

Aggressive IV hydration with normal saline is the first-line treatment for hypercalcemia of malignancy, promoting renal calcium excretion before adding bisphosphonates.

Which chemotherapy agent is MOST associated with anaphylaxis during infusion, requiring premedication?

Answer: Paclitaxel

Paclitaxel, formulated in Cremophor EL, frequently causes hypersensitivity reactions and requires premedication with corticosteroids, diphenhydramine, and H2 blockers.

A patient with lung cancer on opioids develops progressive confusion, hyperreflexia, and seizures. Labs show serum sodium of 118 mEq/L. What is occurring?

Answer: Syndrome of inappropriate antidiuretic hormone (SIADH)

SIADH causes dilutional hyponatremia with neurological manifestations; it is common in small cell lung cancer due to ectopic ADH secretion.

What is the nurse's FIRST action when a patient on chemotherapy develops signs of anaphylaxis (urticaria, bronchospasm, hypotension)?

Answer: Stop the infusion immediately, call for help, and prepare epinephrine

Anaphylaxis is a life-threatening emergency requiring immediate infusion cessation, activation of emergency response, and administration of epinephrine.

A patient with prostate cancer metastatic to the spine develops sudden onset of lower extremity weakness and urinary retention. What emergency should the nurse suspect?

Answer: Spinal cord compression from epidural metastasis

New neurological deficits and urinary retention in a cancer patient with spinal metastases indicate malignant spinal cord compression, a neurological emergency requiring immediate intervention.

Which finding indicates a patient with cancer-associated hypercoagulability has developed a pulmonary embolism (PE)?

Answer: Sudden dyspnea, pleuritic chest pain, and tachycardia

Sudden dyspnea, pleuritic chest pain, and tachycardia are the classic triad of pulmonary embolism, a common life-threatening complication in cancer patients due to hypercoagulability.