1
ONCOLOGIC EMERGENCIES STUDY
GUIDE TIPS 2026 LATEST
Learning Objectives
• Discuss the major classifications and sub-classifications of oncologic emergencies
• Discuss the treatment and nursing care management for each specific emergency
What is an Oncologic Emergency?
With a greater range of treatments available, many forms of cancer can now be
characterized as chronic or long-term conditions with periods of treatment leading to
periods of remission, sometimes followed by recurrence and further treatment.
Occasionally, more urgent, acute, medical problems occur in patients with cancer and these
require timely diagnosis, intervention and treatment if medium or long-term survival is not
to be adversely affected. Such problems can be described as oncological emergencies.
A clinical condition resulting from a metabolic, neurologic, cardiovascular,
hematologic, and/or infectious change caused by cancer or its treatment that requires
immediate intervention to prevent loss of life or quality of life.
ANTICIPATE potential emergencies & RECOGNIZE them early!
MAN 732 | Oncologic Nursing 1
,2
- Regular monitoring of lab values every shift by RN.
- Need for RN & AP communication & documentation throughout the shift—
updating eachother, sharing “gut feelings” of observations— “something just
doesn’t seem right”
- Identification of risk factor(s): Is there a history of MI, multiple surgeries, DVTs,
drug abuse, etc.
- Review of admission history if RN has not cared for assigned patient; review,
patient 24°flow sheet, & post-pain scores.
- Educate patients/families of potential problems and need to notify RN/AP as
soon aspossible.
CLASSIFICATIONS
• Cardiovascular System Emergencies
• Hematologic Emergencies
• Central Nervous System Emergencies
• Infectious Emergencies
• Metabolic Emergencies
CARDIOVASCULAR SYSTEM
• Pericardial Effusion
MAN 732 | Oncologic Nursing 2
,3
• Cardiac tamponade
Malignant Pericardial Effusions
• Often are undiagnosed in patients with cancer.
• Most effusions develop from metastatic lung or breast cancer
• Other causes include malignant melanoma, leukemia, lymphoma, radiation
therapy to the chest wall, and chemotherapy agents.
Cardiac Tamponade
Cardiac tamponade: An acute form of a pericardial effusion caused by cancer (most
commonly lung cancer) and/or fluid accumulation around the heart consisting of malignant
cells.
• Is the accumulation of fluid in the pericardial space.
• fluid compresses the heart
= expansion of the ventricles and cardiac filling during diastole
= ventricular volume and cardiac output
= the heart pump fails and circulatory collapse and failure develops.
• With gradual onset, fluid accumulates steadily and the outer layer of the
pericardial space stretches to compensate for the rising pressure. Large amounts
MAN 732 | Oncologic Nursing 3
, 4
of fluid accumulate before symptoms of heart failure occur. With rapid onset,
pressures rise too quickly for the pericardial space to compensate.
Most common causes of Cardiac Tamponade
- cancerous tumors
- cancer treatment
• Radiation therapy of 4,000 cGy or more to the mediastinal areas has also been
implicated in pericardial fibrosis, pericarditis, and resultant cardiac tamponde.
Untreated pericardial effusion and cardiac tamponade lead to circulatory
collapse and cardiac arrest.
Nursing Care Management
• Assess for hypotension, muffled heart sounds, tachycardia, dyspnea, and decreased
level of consciousness.
• Monitor vital signs and oxygen saturation frequently
• Assess for pulsusparadoxus
• Monitor ECG tracings
• Assess heart and lung sounds, neck vein filling, LOC, respiratory status and skin color
and temperature
• Monitor and record intake and output
MAN 732 | Oncologic Nursing 4
ONCOLOGIC EMERGENCIES STUDY
GUIDE TIPS 2026 LATEST
Learning Objectives
• Discuss the major classifications and sub-classifications of oncologic emergencies
• Discuss the treatment and nursing care management for each specific emergency
What is an Oncologic Emergency?
With a greater range of treatments available, many forms of cancer can now be
characterized as chronic or long-term conditions with periods of treatment leading to
periods of remission, sometimes followed by recurrence and further treatment.
Occasionally, more urgent, acute, medical problems occur in patients with cancer and these
require timely diagnosis, intervention and treatment if medium or long-term survival is not
to be adversely affected. Such problems can be described as oncological emergencies.
A clinical condition resulting from a metabolic, neurologic, cardiovascular,
hematologic, and/or infectious change caused by cancer or its treatment that requires
immediate intervention to prevent loss of life or quality of life.
ANTICIPATE potential emergencies & RECOGNIZE them early!
MAN 732 | Oncologic Nursing 1
,2
- Regular monitoring of lab values every shift by RN.
- Need for RN & AP communication & documentation throughout the shift—
updating eachother, sharing “gut feelings” of observations— “something just
doesn’t seem right”
- Identification of risk factor(s): Is there a history of MI, multiple surgeries, DVTs,
drug abuse, etc.
- Review of admission history if RN has not cared for assigned patient; review,
patient 24°flow sheet, & post-pain scores.
- Educate patients/families of potential problems and need to notify RN/AP as
soon aspossible.
CLASSIFICATIONS
• Cardiovascular System Emergencies
• Hematologic Emergencies
• Central Nervous System Emergencies
• Infectious Emergencies
• Metabolic Emergencies
CARDIOVASCULAR SYSTEM
• Pericardial Effusion
MAN 732 | Oncologic Nursing 2
,3
• Cardiac tamponade
Malignant Pericardial Effusions
• Often are undiagnosed in patients with cancer.
• Most effusions develop from metastatic lung or breast cancer
• Other causes include malignant melanoma, leukemia, lymphoma, radiation
therapy to the chest wall, and chemotherapy agents.
Cardiac Tamponade
Cardiac tamponade: An acute form of a pericardial effusion caused by cancer (most
commonly lung cancer) and/or fluid accumulation around the heart consisting of malignant
cells.
• Is the accumulation of fluid in the pericardial space.
• fluid compresses the heart
= expansion of the ventricles and cardiac filling during diastole
= ventricular volume and cardiac output
= the heart pump fails and circulatory collapse and failure develops.
• With gradual onset, fluid accumulates steadily and the outer layer of the
pericardial space stretches to compensate for the rising pressure. Large amounts
MAN 732 | Oncologic Nursing 3
, 4
of fluid accumulate before symptoms of heart failure occur. With rapid onset,
pressures rise too quickly for the pericardial space to compensate.
Most common causes of Cardiac Tamponade
- cancerous tumors
- cancer treatment
• Radiation therapy of 4,000 cGy or more to the mediastinal areas has also been
implicated in pericardial fibrosis, pericarditis, and resultant cardiac tamponde.
Untreated pericardial effusion and cardiac tamponade lead to circulatory
collapse and cardiac arrest.
Nursing Care Management
• Assess for hypotension, muffled heart sounds, tachycardia, dyspnea, and decreased
level of consciousness.
• Monitor vital signs and oxygen saturation frequently
• Assess for pulsusparadoxus
• Monitor ECG tracings
• Assess heart and lung sounds, neck vein filling, LOC, respiratory status and skin color
and temperature
• Monitor and record intake and output
MAN 732 | Oncologic Nursing 4
