Tumor Lysis Syndrome: A Practical Guide for Nurse Practitioners

Tumor Lysis Syndrome

BACKGROUND

Tumor lysis syndrome is a life-threatening oncologic emergency in adult and pediatric patients with hematologic cancer. It occurs most often in malignancies with rapid cell turnover and large tumor burden, but its incidence has risen in solid tumors. The subsequent release of tumor cell contents into the bloodstream results in dangerous electrolyte and metabolic disturbances.

OBJECTIVE

To provide acute and critical care nurses with a comprehensive review targeted to critical care nursing practice. Recognition of hallmark signs and symptoms will improve early detection and intervention.

METHODS

A literature review was performed using the following keywords: tumor lysis syndrome, diagnosis, nursing, early detection, and early diagnosis in PubMed and tumor lysis syndrome, diagnosis, early diagnosis, and early detection in CINAHL. Included studies were published in 2014 or later.

RESULTS

Tumor lysis syndrome causes hyperkalemia, hyperphosphatemia, hypocalcemia, and hyperuricemia. These laboratory disturbances can lead to potentially destructive complications including renal injury, arrhythmias, seizures, and neuromuscular instability.

DISCUSSION

Acute and critical care nurses can use disease-related risk factors and clinical presentations associated with these laboratory derangements to determine the level of monitoring and intervention necessary for impacted patients.

CONCLUSIONS

Knowledge of risk factors and clinical presentations will enhance the ability of nurses in clinical practice to prevent adverse events and complications that result from tumor lysis syndrome.

Oncological Emergencies from Pathophysiology and Diagnosis to Treatment: A Narrative Review

Oncological emergencies are defined as any acute possible morbid or life-threatening events in patients with cancer either because of the malignancy or because of their treatment. These events may occur at any time during malignancy, from symptoms present to end-stage disease. The aim of this study is the review of urgent conditions results from cancer or cancer treatment side effects that need to be addressed immediately. In this study, a comprehensive and in-depth narrative review was carried out by searching the databases of PubMed, Scopus, Science Direct, Google Scholar with the keywords of "cancer, emergency, metabolic emergency, neutropenic fever" along with the words, "tumor lysis syndrome, chemotherapeutic emergency, diagnosis, treatment " in last two decades. Patients suffering from cancer mostly face the challenges that we are classified in different categories, including metabolic, hematologic, cardiovascular, neurologic, respiratory, infectious, and chemotherapeutic emergencies. These patients mostly complain of headaches, nausea, pain, and fever. In conclusion, knowledge of oncology emergencies and palliative care as part of a team approach is critical for treating cancer patients. In this light, it is pivotal for physicians to focus on the early detection of oncological emergencies. Moreover, training programs for cancer patients help them to timely recognize and report the oncologic emergency symptoms, leading to avoid deleterious consequences and unnecessary healthcare costs as well as improve the quality of life in these patients.