Alterations in Immunity & Oncologic Emergencies Notes

Alterations in Immunity & Oncologic Emergencies

Priority in Angioedema

  • Determine #1 priority in a client experiencing angioedema:
    • Airway: Maintaining airway patency is crucial in cases of angioedema due to the risk of obstruction.

Interventions for Angioedema

  • Three important interventions in order of priority:

    1. Epinephrine (Epi): Immediate administration to counteract severe allergic reactions and constrict blood vessels, aiding in airway swelling reduction.
    2. Airway Oxygenation: Providing supplemental oxygen to ensure adequate oxygenation if airway compromise occurs.
    3. IV Fluids: Administer fluids to maintain circulatory volume and support blood pressure.

  • Comparison with others: It’s advisable to compare personal answers with the established table to ensure alignment on priorities and interventions.

Respiratory Concerns in Angioedema

  • Most concerning breath sound:
    • Stridor: Indicates upper airway obstruction and is a critical sign in angioedema patients.

Anaphylaxis, Allergens, and Immunoglobin E (IgE)

  • Relationship:
    • An allergen is recognized as an antigen that invokes an immune response.
    • Exposure to allergens can cause anaphylaxis, a severe, potentially life-threatening allergic reaction mediated by the antibodies known as IgE targeting the allergen.

Tumor Lysis Syndrome (TLS)

  • Definition:

    • TLS occurs when tumor cells are destroyed, leading to the release of intracellular components into the bloodstream. The body may not be able to swiftly eliminate these cellular products, causing potential metabolic disturbances.

  • Occurrence:

    • TLS is more common in fast-growing cancers due to the larger number of rapidly dividing cells that can be destroyed at once.

  • Prioritized Body Systems:

    1. Kidneys: At high risk for damage due to the accumulation of metabolic byproducts (e.g., ↑ phosphate and potassium), which can lead to Acute Kidney Injury (AKI).
    2. Heart: Essential to monitor as electrolyte imbalances can cause cardiac arrhythmias and complications.

Disseminated Intravascular Coagulation (DIC)

  • Definition:

    • DIC is a pathologic response involving widespread clotting in the body due to the consumption of clotting factors, which subsequently leads to bleeding because the availability of these factors is depleted.

  • Oncologic Emergency Role:

    • DIC is considered an oncologic emergency primarily because it can be triggered by sepsis, a condition that cancer patients are vulnerable to due to immune dysfunction, leading to a high risk of death if not managed promptly.