OCC Oncology Emergencies & Complications Flashcards

A patient 48 hours post-chemotherapy develops fever of 101.5°F, chills, and an ANC of 300/mm³. What is the nurse's IMMEDIATE priority?

Answer: Obtain blood cultures and initiate broad-spectrum antibiotics within 60 minutes per protocol

Febrile neutropenia is a life-threatening emergency; blood cultures must be obtained and broad-spectrum antibiotics initiated within 60 minutes of fever onset.

Which clinical findings are characteristic of superior vena cava (SVC) syndrome in an oncology patient?

Answer: Facial plethora, upper extremity edema, and distended neck veins

SVC syndrome presents with facial plethora, upper extremity and facial edema, and distended neck veins due to obstruction of venous return from the upper body.

A patient undergoing aggressive chemotherapy for leukemia develops hyperkalemia, hyperphosphatemia, hypocalcemia, and elevated uric acid. What syndrome is occurring?

Answer: Tumor lysis syndrome

Tumor lysis syndrome results from rapid destruction of cancer cells releasing intracellular contents, causing the classic electrolyte pattern of hyperkalemia, hyperphosphatemia, hypocalcemia, and hyperuricemia.

Which intervention is the MOST critical in preventing tumor lysis syndrome in high-risk patients?

Answer: Aggressive IV hydration and allopurinol or rasburicase administration before chemotherapy

Aggressive IV hydration dilutes metabolites and promotes renal excretion, while allopurinol or rasburicase prevents uric acid accumulation before chemotherapy initiation.

A cancer patient on opioids and vincristine develops abdominal distension, absence of bowel sounds, and no bowel movement in 5 days. What complication is suspected?

Answer: Ileus/bowel obstruction from vincristine-induced neurotoxicity

Vincristine causes autonomic neuropathy leading to paralytic ileus, particularly when combined with opioids, presenting with absent bowel sounds and obstipation.

A patient receiving high-dose cyclophosphamide reports severe bladder pain, urinary frequency, and grossly bloody urine. What complication has occurred?

Answer: Hemorrhagic cystitis from acrolein metabolite accumulation

Hemorrhagic cystitis is caused by acrolein, a toxic metabolite of cyclophosphamide that accumulates in the bladder, causing mucosal damage and bleeding.