Oncology Emergencies:

#1 - Spinal Cord Compression and Superior Vena Cava Syndrome

I. Spinal Cord Compression

A. Pathophysiology

1. At risk cancers

B. Signs and Symptoms

1. Assessment parameters

i. Pain

ii. Motor

iii. Sensory

C. Diagnostics

1. Radiographic

2. Myelogram

D. Treatments

1. Steroids

2. Radiation

3. Surgery

4. Chemotherapy

E. Nursing Care

1. Case Study

A. Pathophysiology

1. Intrinsic

2. Extrinsic

B. Signs and Symptoms

1. Early

2. Late

C. Diagnostics

1. Laboratory values

2. Radiographic

3. Differential

D. Treatment

1. Radiation

2. Medications

3. Symptom control

E. Nursing Care

F. Case Study

Behavioral/Learning Objectives:

1. Recognize signs and symptoms of Spinal Cord Compression and Superior Vena Cava Syndrome.
2. Identify nursing assessment and diagnostic procedures for Spinal Cord Compression and Superior Vena Cava Syndrome.
3. Describe treatment and nursing care associated with Spinal Cord Compression and Superior Vena Cava Syndrome.

#2 - Pericardial Effusion/Cardiac Tampanode and Pleural Effusion

I. Pericardial Effusion/Cardiac Tampanode

A. Pathophysiology

1. Etiology

2. Patient at Risk

B. Signs and Symptoms

1. Early
2. Late

C. Diagnosis

1. Physical exam
2. Pulsus paradoxus
3. Echocardiogram

D. Treatment Goals

1. Remove fluid
2. Prevent reaccumulation

E. Treatment Options

1. Pericardiocentisis
2. Treat underlying cancer
3. Sclerosis

F. Nursing Care

1. Pericardiocentisis
2. Treat underlying cancer
3. Sclerosis

G. Case Study

A. Pathophysiology

1. Etiology
2. High risk

B. Signs and Symptoms
C. Physical
D. Diagnosis

1. Radiology
2. Thoracentisis

i. Transudative
ii. Exudative

E. Treatment

1. Systemic
2. Pleuradesis
3. Factors to consider
4. Contraindications

F. Nursing Care

1. Case Study

Behavioral/Learning Objectives:

1. Recognize signs and symptoms of Pericardial Effusion/Cardiac Tamponade and Pleural Effusion.
2. Identify nursing assessment and diagnostic procedures for Pericardial Effusion/Cardiac Tamponade and Pleural Effusion.
3. Describe treatment and nursing care associated with Pericardial Effusion/Cardiac Tamponade and Pleural Effusion.

#3 - Hypercalcemia/SIADH/TLS

I. Hypercalcemia

A. Pathophysiology

1. Primary Hyperthyroidism
2. Malignancy
3. High risk
4. Prognosis

B. Signs and Symptoms

1. Physical
2. Neurological

C. Goals of treatment
D. Treatment options

1. Biophosphates
2. Antidotes
3. Phosphate Salts
4. Corticosteroids
5. Calcimimetic agent
6. Treatment of underlying malignancy

E. Nursing Care

1. Assessment parameters
2. Laboratory values
3. Patient Education

F. Case Study

A. Pathophysiology

1. Antidiuretic hormone secretion
2. Hyponatremia

B. Etiology

1. Pituitary secretion
2. Ectopic secretion

C. Clinical Features

1. Laboratory values
2. Diagnosis

D. Treatment

1. Asymptomatic
2. Symptomatic
3. Chronic

E. Nursing Care

1. Level I
2. Level II
3. Level III

F. Case Study

A. Pathophysiology

1. Laboratory
2. Clinical

B. Risk Factors

1. Tumor type

C. Timing of symptoms

1. Early signs
2. Laboratory values

D. Treatment

1. Prophylaxis
2. Management strategies

E. Nursing Care

F. Case Study

Behavioral/Learning Objectives:

1. Describe signs and symptoms of Hypercalcemia, SIADH, and Tumor Lysis Syndrome(TLS).
2. Identify nursing assessment and diagnostic procedures for Hypercalcemia, SIADH, and Tumor Lysis Syndrome(TLS).
3. Describe treatment and nursing care associated with Hypercalcemia, SIADH, and Tumor Lysis Syndrome(TLS).

#4 - Neutropenia and Infection/Sepsis

I. Neutropenia

A. Definitions

1. Classifications

i. Mild
ii. Moderate
iii. Severe

B. Signs and Symptoms

1. Physical symptoms

C. Diagnosis

1. Laboratory values

D. Causes

1. Decrease production
2. Increased destruction

E. Treatment
F. Nursing Care
G. Case study

A. Neutropenic fever

1. Pathophysiology
2. Microbiology

i. Antibiotic therapy

(1) Mono-therapy
(2) Dual-therapy

3. Clinical presentation

i. Diagnostics

(1) Laboratory

ii. Low risk features
iii. High risk features

4. Treatment and supportive care

i. Nursing Care

B. Sepsis

1. Mechanisms at work

i. Causes

2. Symptoms

i. Systemic
ii. Mediated

3. History and physical findings
4. Diagnosis

i. Laboratory

ii. Radiologic

5. Complications
6. Treatments

i. Procedural
ii. Supportive

7. Nursing Care

i. Case Study

Behavioral/Learning Objectives:

1. Identify the signs and symptoms of Neutropenia and Infection/Sepsis.
2. Identify nursing assessment and diagnostic procedures for Neutropenia and Infection/Sepsis.
3. Describe treatment and nursing care associated with Neutropenia and Infection/Sepsis.

#5 - Anemia, Thrombocytopenia and DIC (Disseminated Intravascular Coagulopathy)

I. Anemia

A. Definitions

1. Causes

i. Treatment related
ii. Cancer related

2. Etiology

i. Diagnostics

(1) Laboratory

(i) Normal values

B. Treatment options

1. Supportive care

i. Transfusions

(1) Risks vs benefit

ii. Growth factors

C. Nursing care
D. Case Study

A. Definitions

1. Causes

i. Treatment related
ii. Cancer related

2. Etiology

i. Differential diagnosis
ii. Diagnostics

(1) Laboratory

(i) Normal values

B. Treatment options

1. Supportive care

i. Transfusions

(1) Risks vs benefit

C. Nursing care
D. Case Study

A. Definition

1. Background

i. History of illness
ii. Frequency of occurrence

B. Pathophysiology

1. Signs and Symptoms

i. Acute
ii. Chronic

C. Diagnosis

1. Laboratory
2. Other tests

D. Treatment options

1. Anticoagulants
2. Recombinant human activated protein C
3. Transfusions
4. Antifibrinolytic agents

E. Nursing Care
F. Case study

Behavioral/Learning Objectives:

1. Explain the signs and symptoms of Anemia, Thrombocytopenia and DIC (Disseminated Intravascular Coagulopathy).
2. Identify nursing assessment and diagnostic procedures for Anemia, Thrombocytopenia and DIC (Disseminated Intravascular Coagulopathy).
3. Describe treatment and nursing care associated with Anemia, Thrombocytopenia and DIC (Disseminated Intravascular Coagulopathy).

#6 - Chemotherapy Extravasation

I. Patients at risk

A. Patient related
B. Drug Related
C. Iatrogenic

A. Irritants
B. Vesicants

A. Assessment
B. Documentation

A. Prevention
B. Irritant
C. Vesicant

1. Central line
2. Peripheral line

Behavioral/Learning Objectives:

1. Identify the signs and symptoms of Chemotherapy Extravasation.
2. Identify nursing assessment and diagnostic procedures for Chemotherapy Extravasation.
3. Describe treatment and nursing care associated with Chemotherapy Extravasation.

Accreditation Information

Certified Oncology Nurses: Our approved provider status with the ANCC qualifies our continuing education programs to be used as Professional Development Points for recertification purposes.

Nurses – Academy Medical Systems is an approved provider of continuing nursing education by the Illinois Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.

Academy Medical Systems is also a provider approved by the California Board of Registered Nursing, provider #CEP14413, for 9 hours. AMS is an approved provider of the Florida Board of Nursing, provider # 50-19, for 9 hours.

Iowa Nurses - The Iowa Board of Nurses will recognize the recorded webinars as a home study program. They recognize our ANCC approved provider status as well as our CA and Fl Board of Nursing provider approval for home study products for nurses in Iowa.

All other states recognize our approved provider status listed in the above text for continuing education credit for nurses. 9 contact hours will be rewarded to nursing professionals at the completion of this workshop.

Dietitians – Academy Medical Systems is a Continuing Professional Education (CPE) Accredited Provider with the Commission on Dietetic Registration (CDR). Registered dietitians (RDs) and dietetic technicians, registered (DTRs) will receive 9 continuing professional education units (CPEUs) for completion of this material.

Exercise Physiologist – ACSM recognizes AMS’s approved provider status with the ANCC and will honor continuing education hour for Certified Exercise Physiologist recertification purposes.

Physical Therapists – PTs in the following states will receive 9 contact hours: CO, CT, DE, IA, ID, KS, MI, MA, MT, NE, NH, NM, NC, ND, PA, RI, SC, SD, TN, UT, VA, VT, WA, WY.

Occupational Therapists – Occupational Therapist will receive 9, type II, continuing education hours for completion this program and a test score of 70% or better. AMS is an approved provider for the AOTA , provider # 5470. Intermediate educational level.

Certified Athletic Trainers – Academy Medical Systems is recognized by the Board of Certification (BOC) to offer continuing education for certified athletic trainers. 9 hours will be awarded at the completion of this program.

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