Understanding and Managing Oncologic Emergencies: A Resource for Nurses

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Preface

The impetus for the development of this book was the need for a nursing reference dedicated solely to oncologic emergencies, a subject that is critical to the quality of life and survival of individuals with a history of cancer. This book is designed to be the definitive, practical, one-stop guide to understanding and managing oncologic emergencies from a nursing perspective.

As cancer survival intervals increase, early recognition of and prompt intervention for disease- or treatment-related oncologic complications are becoming more important than ever. Nurses are key to improving patient outcomes when an oncologic emergency occurs. Devastating functional losses may be limited, a reasonable quality and length of life maintained, and the progression to a life-threatening emergency prevented by the actions of alert nurses.

Nurses involved in the care of patients with a history of cancer—whether the patients are newly diagnosed, are in the process of being treated, or have completed treatment years ago—will find up-to-date, comprehensive information within this book regarding the 10 most common oncologic emergencies. Understanding and Managing Oncologic Emergencies: A Resource for Nurses provides complete information in a user-friendly format that will help readers to

• Identify which patients are at increased risk for oncologic emergencies.
• Recognize the signs and symptoms associated with the complications.
• Understand the underlying pathophysiologic processes.
• Learn pertinent diagnostic evaluations and therapeutic interventions.
• Assess patients appropriately.
• Apply nursing management strategies across a continuum from acute through chronic care.

Chapters are presented alphabetically for easy location of topics of interest, and each follows a consistent structure to facilitate information gathering. Tables, figures, and boxes are liberally incorporated throughout the text to summarize or emphasize detailed information and to make the book a quick reference.

Each in-depth chapter begins with an overview of the epidemiology of the oncologic emergency, followed by discussion of the associated pathophysiologic mechanisms, clinical manifestations, patient assessments, diagnostic evaluations, and therapeutic management modalities. Nursing management strategies, including prevention and early detection measures, ongoing patient assessments and symptom management, treatment and side effect management, rehabilitation and palliative care, and patient and caregiver education recommendations are presented in detail. Terms or concepts that may be unfamiliar are explained throughout, and an extensive reference list concludes each chapter, guiding readers to additional resources on each topic.

Oncology nurses are the natural audience for this book, but others practicing in a variety of patient care settings—ambulatory care, medical-surgical hospital units, home care, palliative care, critical care, emergency departments, and physician offices—as well as nurse educators and those preparing for oncology nursing certifications or advanced practice roles in oncology also will find valuable information within this clinical reference.

It is my hope that this book has met the goal of being the definitive nursing resource for complete, detailed information regarding all aspects of understanding and managing the care of patients experiencing oncologic emergencies.

Thanks are due to many people who were essential to the creation of this comprehensive nursing resource. I gratefully acknowledge the contributions of the chapter authors who shared their knowledge and expertise. Their dedication to creating a quality reference book is apparent in their chapters. I commend the editorial staff of the ONS Publishing Division for their expert guidance and expertise in shaping the manuscript into a quality book.

I am also fortunate to have had the resources of two highly regarded medical libraries literally at my fingertips, both physically and electronically: the libraries of the Weill Medical College of Cornell University and Memorial Sloan-Kettering Cancer Center. Their staffs were unfailingly helpful. I also thank the Department of Medical-Surgical Nursing at Weill Cornell Medical Center of New York-Presbyterian Hospital for supporting my work on this book over a long period of time.

I send my love to my children, Andrea Kaplan and Richard Kaplan, and Richard's wife, Lydie, for their enthusiasm and encouragement along every step of the way. We all take great pride in each other. Lastly, I acknowledge the contributions of my husband, Jack Lubowsky, PhD, whose unstinting love and support encouraged me to take on this challenge and shepherd it through to completion. He patiently worked on table layouts for my chapters and created several figures for the book. To him I dedicate this book.