Tumor lysis syndrome- Acute tumor lysis disease has metabolic differences that are the direct result of fast release of intracellular contents during the lysis of harmful cells. This usually happens in patients with ALL or Brurkitt lymphoma during the first treatment but may happen in a sudden and unplanned way before the beginning of therapy. Tumor lysis syndrome may also happen in other cancer growths that have a large tumor load, are very sensitive to the use of powerful drugs, or have a fast-proliferative rate. The metabolic differences include hyperuricemia, hypocalcemia, hyperphosphatemia, and hyperkalemia. The crystallization of uric acid can happen in cases of hyperuricemia can lead to nerve disease, tubular injury, sudden and serious kidney-related failure, and death. Risks for development of tumor lysis syndrome include high white blood cell count as an identification of a disease or problem, or its cause), large tumor load, sensitivity to chemo medications. Children may develop a spectrum of medicine-based signs of sickness, including flank pain, feelings of being tired, …show more content…
nausea and vomiting, muscle cramps, tetany, or seizures. Management of tumor lysis syndrome consists of early identification of patients at risk, disease-preventing actions, and proactive interventions. Patients at risk should have serum chemistries and urine pH monitor often, strict record of intake and output, and aggressive IV fluids. Medicines that reduce Uric acid creation and increase excretion of by-products of purine metabolism, such as allopurinol, are often used Hyperleukocytosis- A peripheral white blood cell counts greater than 100,000/mm3, can lead to capillary blocking, microinfarction, and improper organ function. Children often experience breathing and lung related depression and blue skin from not having enough oxygen. They also experience nerve-related changes, including changed level of alertness, visual disturbances, confusion, ataxia, and insanity. Management consist of fast cytoreduction by chemo medications, hydration, urinary alkalization, and allopurinol. Leukophoresis or exchange transfusion may be necessary. Superior venal cava syndrome- obstruction may create an oncologic emergency for a child with cancer.
Space occupying lesions in the chest, especially from Hodgkin disease and NHL, may cause superior vena cava disease, leading airway problems and possibly to respiratory failure. Up to 40% of all SVCS cases are due to implantable intravenous devices, such as central vein-related and ports, due to a blood clot or a fibrotic reaction. Children are at first with cyanosis of the neck, face, and upper chest; facial and upper extremity edema; and distended neck and chest veins. They may be nervous/eager and have difficulty breathing, wheezing or frequent cough from airway obstruction. Management consist of airway protection and assistance with breathing and lung related worry and depression. Prompt treatment is started, and signs of sickness usually improve as the disease is effectively
treated. Spinal cord compression- Different cancer tumors may rapidly grow or interfere with the spinal cord causing acute signs of cord compression. Children with primary CNS tumors can have tumors that start or spread to the spinal cord. Other solid tumors, like neuroblastoma or rhabdomyosarcoma, can spread to the spinal cord and cause pressure. Back pain is a common initial visible sign, but other signs of sickness can include feeling change, extremity weakness, loss of bowel and bladder function, and breathing and lung difficulties. Careful physical examination is extremely important in early detection of signs of sickness. A MRI is the gold standard for identification of a disease or problem. Treatment may include high dose steroids to reduce fluid retention and help decrease signs of sickness, and rapid treatment such as emergency radiation or laminectomy if so needed. Disseminated intravascular coagulation- Widespread infections in the sick child are considered emergency situations. Infection from bacteria or fungus can result in many difficulties, including disseminated intravascular coagulation (DIC). Children with DIC form large amounts of microthrombi throughout the blood vessels due to hyperactivation of the clotting cascade, downregulation of anticoagulants, and impaired fibrinolysis, which leaves the child susceptible to sudden, dangerous bleeding, life-threatening hemorrhage can happen from DIC with thrombocytopenia (platelet count of less than 20,000/mm3). Treatment is focused on identifying in treating the underlying cause, along with heparin infusion to decrease the number of microthrombi and cryoprecipitate to replace Fibrinogen.
A 54 year old female was presented with complaints of lethargy, excessive thirst and diminished appetite. Given the fact that these symptoms are very broad and could be the underlying cause of various diseases, the physician decided to order a urinalysis by cystoscope; a comprehensive diagnostic chemistry panel; and a CBC with differential, to acquire a better understanding on his patient health status. The following abnormal results caught the physician’s attention:
Context: Hypercalcemia is a commonly encountered clinical problem. In the majority (90%) of the cases it is either due to malignancy or primary hyperparathyroidism and is rarely due to granulomatous disease.
The chemistry test shows the levels of electrolytes found in the blood: sodium, potassium, chloride, phosphorus, magnesium and calcium. Imbalances in these electrolytes can cause complications, which especially in the case of potassium, can be deadly. Also shown by the chemistry test, blood urea nitrogen and creatinine levels can show how well the patient’s kidneys are functioning in filtering waste from the blood. Trauma and blood loss can affect how the kidney’s function not only in filtering waste, but also in acid-base balance, and balancing electrolyte levels. Another marker of kidney function is the glomerular filtration rate, which measures the rate filtrate is created by the glomerulus of the kidney (Winkelman, 2016). This is controlled by the kidneys themselves, meaning changes in the function of the kidneys can lead to an altered filtration rate (Winkelman, 2016). Lactic acid is measured by the chemistry test also, and an increase in lactic acid can signify acidosis caused by the lactic acid being formed by cells that do not have adequate oxygen to process glucose for energy (Workman, 2016). This decrease in available oxygen could be caused by damage to or impairment of the lungs. Carbon-dioxide, which is also measured by the chemistry test, can show
... Various treatment modalities have been described, including lobectomy or segmentectomy, systemic artery to pulmonary artery anastomosis and endovascular treatment. Differentiation between this condition from classic sequestration has important treatment implications as it may allow non-operative management (angiographic embolization) of the aberrant systemic artery.
Although lung cancer is generally operable, by using either traditional open surgery, or one of the less intrusive and more sophisticated video-assisted thoracoscopic surgeries (VATS), often it may not be considered to be the best option for a patient. Where ill-health is a factor, or either the size and location of the tumor is deemed to be a consideration, other forms of treatment may well have to be considered.
If lymphatic cancer is found treatment is required immediately to get rid of the cancer cells as soon as possible so damage as is not done to normal cells.
Hinkle, Janice, and Kerry Cheever. “Management of Patients with Chronic Pulmonary Disease." Textbook of Medical-Surgical Nursing, 13th Ed. Philadelphia: Lisa McAllister, 2013. 619-630. Print.
...ystems action leading to coma and death. Alkalosis is when the bloods pH increases to become more alkaline, it results in over excitement of the nervous system leading to convulsions. There are key pH changers that can occur; vomiting can lead to alkalosis, diarrhea can lead to acidosis. Kidney disfunction could happen either way, if the kidneys get messed up then blood pH can be all over the place.
The lymphatic system is very similar, and works with and directly at the side of the cardiovascular system. The lymphatic system has a network of vessels like the circulatory system which pump a plasma-like fluid called lymph around it’s own lymph vessels, and are found in most other tissues of the body, except the central nervous system.
Mr. GB is a 78 year old white male admitted to Bay Pines VAMC on 6/18/96. for " atypical chest pain and hemoptysis". V/S BP 114/51, P 84, R 24, T 97.4. He seems alert and oriented x 3 and cheerful. Bowel sounds present x 4. Pt. has a red area on his coccyx. Silvadene treatments have been started. Pt. Has a fungal lung infection with a pleural suction drainage tube inserted in his chest . Pt is extremely thin with poor skin turgor with a diagnosis of cachexia ( wasting) secondary to malnutrition and infection. Patient is no known allergies to drugs but is allergic to aerosol sprays disinfectants and dust.. Advanced directives on chart. Code status DNR. Primary physician Dr. R, Thoracic surgeon Dr. L. Psychology Dr.W. There is PT, OT Dietary and Infectious Disease consults when necessary. He lives with his wife who he has been married to for 56 years. His son and his daughter come to visit him. He does not smoke. He wears dentures but did not bring them. He dose not use a hearing aid but he does have a hearing deficit.
“The lymphatic system is a vital and integral part of the cardiovascular system”. The lymphatic system contains many structures which consist of lymphatic vessels, lymph fluid, lymph cells, lymph nodes and other substances. (Hastie, 2012) The lymphatic system consists of a network of fine tubes or vessels which ramify throughout the body similar to blood vessels. Unlike the blood the fluid is moved by the muscles and limbs. The lymph vessels have fine walls, so water can pass easily through them. The main role of the lymphatic system is too drain off excess fluid from all parts of the body. This prevents the cells getting waterlogged. (Hayes, 2002). Other functions include returning the lymph back to the heart and immune surveillance within
...essive episodes (CareNotes). As chemo is administered, patients may aquire other issues, such as a loss in appitite, less energy, sores in the mouth, pain throughout the body, an increased heartbeat, coughing or breathing issues, and confusion (CareNotes). According to CareNotes, patients must stay away from people that are sick, due to a decreased immune system, and they must drink a lot of water to stay hydrated.
Bratton, R. L., Whiteside, J. W., Hovan, M. J., Engle, R. L., Edwards, F. D. (2008). Diagnosis
Cardiovascular System: He does not experience any chest pain or palpitation. He does not have dyspnea or leg swelling.
Lymphatic System Overview A well-functioning lymphatic system is essential to maintaining good health. The lymphatic system consists of a network of lymph vessels, lymph nodes, lymph ducts, and organs that can be likened to a drainage system in the body. Lymph Drainage Function The lymphatic system’s main task is transporting lymph consisting of.