Describe the pathophysiology clinical manifestations diagnos

Describe the pathophysiology, clinical manifestations, diagnostic tests, and nursing management of patients with an oncologic emergency.

Solution

An oncologic emergency is typically characterized by a condition which is acute and life threatening event directly or indirectly related to a patient\'s tumor or the ongoing treatment. Oncologic emergencies are recognized by their system of origin like metabolic, or as hematologic. However, the symptoms are often only the common problems associated with cancer like nausea, pain, headache, and fever.

For early recognition of oncologic energency, a cancer patient must be carefully monitored and must be  adequately educated about preventative measures and reporting of symptoms to a physician.

Some of its clinical manifestations, pathophysiology, diagnostic tests and nursing may include following;

1. Spinal cord compression may arise from metastatic breast, lung, or prostate cancer and if not treated on time can lead to paralysis, sensory loss, or loss of anal sphincter control. Its initial symptoms may include progressive pain in an axial or radicular distribution. Weakness and sensory loss later arise. Diagnosis is done by taking plain films of the spine or MRI scans, which may show lytic, blastic lesions or erosion of the pedicles. A patient is given corticosteroids as the first treatment followed by radiotherapy.

2. Obstruction of the flow of cerebrospinal fluid (CSF) due to growth of tumor tissue may lead to increased intracranial pressure. Such patients may experience headache, nausea and vomiting, or the onset of seizures. If pressure increases severly, herniation may result. In such cases, intravenous corticosteroids are given as first line of treatment. Patient\'s head is kept elevated for restriction of intravenous fluids and correction of hyperglycemia. Patient is also kept hyperventilated.

3. Hypercalcaemia may occur as a result of elevated calcium level in blood in patients with advance cancers of breast, kidney, lung, prostate, head and neck. It may occur due to bone invasion by the tumour or metastasis, and characterized by nausea, vomiting, constipation, polyuria and disorientation. In such cases, patients are hydrated, kept on diuresis and supplemented with Bisphosphonates.

4. Seizures may occur in patients of brain metastases. Its treatment may include adminintration of diazepam (5 mg) or lorazepam for sustained seizures. Care must be taken to avoid injury.

Other oncologic emergencies may include; altered mental status, Leptomeningeal Disease, Superior vena cava syndrome, Neutropenic sepsis. They all require early diagnosis and appropriate emergency treatment, otherwise, all of them could be life threatening for the patient,