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This Concept Map, created with IHMC CmapTools, has information related to: metabolic oncologic emergencies, can be referred to as paraneoplastic syndrome. small cell lung CA accts for 75% of cases. s/s EARLY: muscle cramps & weaknesss, fatigue, dull senses, low urinary output, inc weight LATE: vomiting, abd cramps, twitching, seizures, cerebral edema, lethargy, anorexia, confusion, H/A seizures, coma, Metabolic Oncological Emergencies types Tumor Lysis Syndrome, IV hydration (200 mL urine/hour) alkanization of urine-sodium bicarb allopurinal (hyperuricemia) osmotic diuretic dialysis Interventions dietary restrictions (K), I&O, daily weights, fluid intake. MONITOR: cardiac funtcion, renal funtion, urine labs., EARLY: muscle cramps & weaknesss, fatigue, dull senses, low urinary output, inc weight LATE: vomiting, abd cramps, twitching, seizures, cerebral edema, lethargy, anorexia, confusion, H/A seizures, coma treatment Diuretics, fluid restriction, treat underlying malignancy, Metabolic Oncological Emergencies types Hypercalcemia ᡃ, Most common metabolic emergency. caused by bone resorption secondary to tumor invasion OR increased levels of PTH secreted by certain CA cells. Can be made worse by inactivity s/s apathy, fatigue, Anorexia, N&V Weakness, low back pain (kidney stones), polyuria, ECG changes, nocturia Decreased LOC, personality changes, coma, apathy, fatigue, Anorexia, N&V Weakness, low back pain (kidney stones), polyuria, ECG changes, nocturia Decreased LOC, personality changes, coma treatment hydration (3 L/day), loop diuretics, biphosphanates, A release of DNA, RNA, potassium & phosphate caused by rapid tumor cell kill, usually chemotherapy. Usually occurs 24-48 hours after chemo. lasts 5-7 days. Causes Hyperkalemia, hyperuricemia (from DNA&RNA) hyperphosphatemia-which leads hypocalcemia. treatment IV hydration (200 mL urine/hour) alkanization of urine-sodium bicarb allopurinal (hyperuricemia) osmotic diuretic dialysis, Metabolic Oncological Emergencies types SIADH, Hypercalcemia ᡃ patho Most common metabolic emergency. caused by bone resorption secondary to tumor invasion OR increased levels of PTH secreted by certain CA cells. Can be made worse by inactivity, hydration (3 L/day), loop diuretics, biphosphanates Interventions decrease risk of pathological fractures, AROM, PROM, pain control, foot board, fluid intake., Diuretics, fluid restriction, treat underlying malignancy Interventions Reorientation, seizure prec. daily weights, fluid restrictions MONITOR: Urine specific gravity, osmolality, serum & urine NA, renal function, electrolytes, lung sounds., SIADH patho can be referred to as paraneoplastic syndrome. small cell lung CA accts for 75% of cases., Tumor Lysis Syndrome Patho A release of DNA, RNA, potassium & phosphate caused by rapid tumor cell kill, usually chemotherapy. Usually occurs 24-48 hours after chemo. lasts 5-7 days. Causes Hyperkalemia, hyperuricemia (from DNA&RNA) hyperphosphatemia-which leads hypocalcemia.