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Regulatory: ATLS - Coggle Diagram
Regulatory: ATLS
S&S
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Cardiac: bradycardia, hypotension or hypertension
Renal: Flank pain, oliguria, cloudy urine
Gastric: N/V, diarrhea, anorexia
Muscle: weakness, cramps, tingles
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Risks
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Fast replicating CAs such as lymphoma, leukemia, and small cell lung cancer
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treatment
prevention: aggressive fluids, allopurinol, and diuretics are given before chemo and after to enhance flushing of electrolytes/uric acid and to prevent the conversion of uric acid for those who are considered at risk
If prevention fails the patient is treated for the particular electrolyte imbalances based on their severity, this can range from kayexalate to insulin/glucose for K+, aluminum hydroxide for phosphate, and a combination of allopurinol/rasburicase to prevent the formation of uric acid or to enhance it's clearance.
If prevention and electrolyte imbalance measures fail hemodialysis can be used to remove excess substances
diagnostics
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Labs: metabolic, creatinine, BUN, Uric acid to detect AKI and associated electrolyte imbalances
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Administration of chemotherapy and radiation can result in the rapid cell death of CA cells. Certain cancers are more at risk of ATLS (lymphoma, leukemia ect.) but there is a chance with any CA treatment. As the cells die and subsequently lyse their intracellular components enter the blood stream. This results in a large excess of primarily intracellular electrolytes such as potassium and phosphate. This results in hyperkalemia and hyperphosphatemia. Excess phosphate will also bind with calcium in the blood resulting in hypocalcemia. Further, the DNA of lysed cells will be broken down and eventually processed in the liver. This results in increased uric acid levels and hyperuricemia. The uric acid can further crystalize in the blood and cause injury to the kidney leading to AKI or kidney failure. Left untreated cardiac dysrhythmias can develop from the effects of hyperkalemia and hypocalcemia. Further damage to the kidneys from uric acid can further worsen the electrolyte imbalances as the body loses it's ability to regulate them. All told a person can present and are at risk of the S&S of the electrolyte imbalances and AKI/kidney failure.