How to spot this catheter complication.

Although it's most commonly seen in cancer patients, superior vena cava syndrome is an easily overlooked threat to anyone who has a central venous access device in place. Carefully piecing together vague patient complaints with data from a chest X-ray and other diagnostic tests will allow prompt treatment.

Superior vena cava syndrome.

OBJECTIVES: To provide a review of the treatment and nursing management of superior vena cava syndrome (SVCS). DATA SOURCES: Review articles, research studies, and book chapters. CONCLUSIONS: SVCS is primarily associated with small cell lung cancer. It usually has a chronic, insidious onset, but may present acutely with laryngeal or cerebral edema. Radiotherapy, chemotherapy, surgery, thrombolysis, and interventional radiology have provided effective treatment. IMPLICATIONS FOR NURSING PRACTICE: Management of the patient with SVCS includes recognition of high-risk patients and initial symptomatology, accurate assessments, appropriate therapies, psychosocial support, and education regarding recurrent SVCS.

Oncologic emergencies in the patient with lymphoma.

OBJECTIVES: To provide a brief overview of the oncologic emergencies most commonly occurring in lymphoma patients. DATA SOURCES: Published articles, research studies, and reference books. CONCLUSIONS: As a result of their malignancy and the treatments they receive, lymphoma patients are at an increased risk for the development of the following oncologic emergencies: superior vena cava syndrome, cardiac tamponade, sepsis, acute tumor lysis syndrome, and increased intracranial pressure. If not recognized and treated quickly, these complications can be deadly. With appropriate medical and nursing management, these emergencies either can be prevented or their complications minimized. IMPLICATIONS FOR NURSING PRACTICE: An awareness of which patients are at risk for these complications and the pathophysiology of each emergency will assist nurses in the implementation of treatment measures.

Metastases that interfere with circulation.

OBJECTIVES: To review the nursing implications of select circulatory problems caused by metastatic cancer. DATA SOURCES: Journal articles, research studies, and book chapters relating to circulatory problems associated with metastatic disease. CONCLUSIONS: During the metastatic process, tumor cells can interfere with circulation. As a result, circulatory impairments can range from life threatening to manifestations that may alter a person's quality of life. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses have a responsibility to seek current knowledge about therapeutic and supportive care for persons experiencing circulatory alterations. Collaboration with colleagues can facilitate patient care in these clinical situations. Patient education can be supportive and may enhance optimal outcomes.

Oncology emergencies.

Oncology patients have numerous complications that are life threatening and may require an admission into the intensive care unit (ICU). Most ICU nurses have a limited understanding of how to assess and treat this type of patient population. Three of the most common oncologic emergencies that can be seen in an ICU are malignant pleural effusion, cardiac tamponade, and superior vena cava syndrome. Each of these disease entities will be defined to introduce the ICU nurse to oncologic emergencies.

Understanding oncologic emergencies.

Cancer can precipitate life-threatening complications. Since the onset of these conditions can be gradual or abrupt, nurses need to be aware of the potential occurrence and treatment options available. This article includes incidence, treatment modalities, and nursing implications of common oncologic emergencies.