Advanced Med Surg - Module 7 Exam 3

SIADH

tumor cells produce abnormal or sustained production of antidiuretic hormone (ADH) from tumors or chemo

SIADH s/s

oliguira, weight gain without edema, mild fatigue to lethargy NVD confusion to seizures and papilledema from low Na, personality changes, brain swelling- decrease in reflexes, coma

SIADH labs

hyponatremia, elevated urine osmolality, decreased serum osmolality

Cardiac tamponade

constriction of the pericardium from fluid accumulation causing decreased CO, pulmonary edema, and HF

Cardiac tamponade s/s

hypotension, JVD, muffle heart sounds (Beck's triad), tachy, hypotension, weak pulses, chest pain, SOB, dyspnea, cough, dysphagia, hiccups, hoarseness, N/V, decreased LOC, pericarditis, excessive perspiration

Cardiac tamponade labs

elevated WBC, lactate, creatine, and troponin

SVC syndrome

obstruction of major vein that carries blood from head, neck, upper chest, and arms to heart by thrombus or extrinsic compression

SVC syndrome s/s

swelling/edema of upper body and arms, JVD, facial/periorbital edema, cerebral edema, layngeal edema, coughing up blood, horner's syndrome

SVC syndrome labs

CXR, CT, MRI to dx, treat with chemo, steroids, radiation, diuretics, TPA, surgery, or temporary stent

Tumor lysis syndrome

spontaneous or chemo induced tumor cell death causing potassium, phoshate, and nuclid cells to be realeased into systemic circulation

Tumor lysis syndrome s/s

weakness, muscle cramps/spasm, AKI - concentrated uric acid, loss of apetite, fatigue, D/N/V, numbness, seizures, hallucinations, heart palpitations/arrythmias

Tumor lysis syndrome labs

hyperkalemia, hyperuricemia, hyperphosphatemia, secondary hypocalcemia, blood testing and monitoring,

DIC

clotting and bleeding at the same time caused by loss of normal hemostatic control in response to sustained and systemic cell injury from chemo

What illness/disease can lead to DIC

malignancy, solid tumors, acute leukemia, sepsis

DIC s/s

bleeding, edema, weakness, muscle cramps, D/N/V, arrythmias, organ failure, concentrated uric acid (AKI)

DIC labs

elevated PT, PTT, FSP, D-dimer, decreased platelets, fibrinogen

hypercalcemia of malignancy

cancer cells secrete PTH-like hormone which is sent into the blood causing hypercalcemia

hypercalcemia of malignancy s/s

apathy, depression, fatigue/lethargy, muscle weakness, decreased LOC, anorexia, N/V, constipation, decreased deep tendon reflexes, ECG changes, polyuria, nocturia, renal dysfunction

hypercalcemia of malignancy treatment

treat primary disease, hydration (3 L/day), biphosphanate therapy IV, loop and other diuretics, dialysis