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N450 Final Unit 11 (1)
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N450 Final Unit 11 (1)
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N450 Final Unit 11Emergencies can be - ANS-Obstructive
Metabolic
Infiltrative
Obstructive- Superior vena cava syndrome - ANS-Obstruction of superior vena cava by tumor or
thrombosis
*Develops over days to weeks, nurses are critical in identification
Obstructive emergency -superior vena cava syndrome At risk populations - ANS-Small cell (Oat
cell) lung cancer
Non-Hodgkin's lymphoma
Metastatic breast cancer
Superior vena cava syndrome S/S - ANS-Facial and periorbital edema
Hoarseness or change in voice
Distention of veins of head, neck, and chest
Seizures
Headache
Superior vena cava syndrome Diagnosis
Treatment based on type of obstruction
Surgery
Radiation
Chemotherapy - ANS-is based on identification of the extent of tumor or detect a thrombus.
Treatment based on type of obstruction - ANS-Surgery
Radiation
Chemotherapy
Superior vena cava syndrome
Nursing Interventions - ANS-Assess organ system malfunction related to ischemia (respiratory,
cardiac, kidney)
Position for venous drainage from torso
Administer diuretics
Administer corticosteroids
Obstructive - Spinal cord compression - ANS-Tumor in epidural space of spinal cord; signs
include
Breast, lung, prostate, GI and renal tumors. Lymphoma and mela
, Obstructive - Spinal cord compression
At risk populations: - ANS-Breast, lung, prostate, GI and renal tumors. Lymphoma and mela
Spinal cord compression
Signs Include: - ANS-Spinal cord compression
Signs Include:
Intense, localized, persistent back pain
Vertebral tenderness aggravated by the Valsalva maneuver
Motor weakness
Sensory paresthesia and loss
Change in bladder or bowel function
Spinal cord compression
Treatment: - ANS-Radiation therapy with steroids
Surgical decompressive laminectomy
Nursing Interventions:
Activity limitations
Pain management
Obstructive
Third space syndrome - ANS-Shifting of fluid from vascular space to interstitial space
At risk populations:
Occurs secondary to extensive surgical procedure, biologic therapy, or septic shock.
Obstructive
Third space syndrome At risk populations: - ANS-Occurs secondary to extensive surgical
procedure, biologic therapy, or septic shock.
Obstructive Signs Include: - ANS-Hypovolemic
Edema
Treatment focuses on replacement of: - ANS-Fluid
Electrolytes
Plasma protein
Nursing Intervention
Monitor fluid balance
Assess for hypervolemia
Metabolic- Syndrome of inappropriate ADH -
A disorder of ________ - ANS-water balance
Obstructive- superior vena cava syndrome At risk populations: - ANS-Small cell lung, pancreas,
duodenum, brain, esophagus, colon, ovary, prostate, bronchus, and nasopharynx, leukemia,
mesothelioma,, Hodgkin's lymphoma.
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