ELECTROLYTES IMBALANCE AMONG PATIENTS WITH ONCOLOGIC EMERGENCIES AT A UNIVERSITY HOSPITAL
Eman Zakaria Abdel-Aziz - BSc nursing, Mansoura University, Egypt
Hanaa Ali Ahmed Elfeky - Assistant Professor of Critical Care and Emergency Nursing Department, Faculty of Nursing, Cairo University, Egypt
Asmaa Ibrahim AboSeda - Lecturer of Critical Care and Emergency Nursing, Faculty of Nursing, Mansoura University, Egypt
ABSTRACT
Background: Oncologic emergencies are life-threatening disorders. They represent an important reason for ICU admission as a result of malignancy-specific electrolyte disorders. Thus, their recognition and treatment are necessary. Aim of the study: To identify types, predisposing factors and manifestations of electrolyte imbalances among adult critically ill patients with oncologic emergencies at one of the university Hospitals - Egypt. Research design: A descriptive research design was followed in this study. Sample: A purposive sample consisting of 100 patients was included. Tools of data collection: Patient's demographic and medical data sheet; Fluid and electrolyte monitoring data sheet, and Oncologic emergency patients' assessment sheet. Results: The great majority (93%) of the studied sample received chemotherapy. Nearly half (45%) of patients were admitted to the ICU with neutropenic fever. Hyponatremia, hypokalemia, and hypocalcemia were the most common electrolyte imbalances on admission to the ICU in percentage of 71%, 50%, and 49% respectively. The most common causes of electrolyte alterations were gastrointestinal problems (anorexia to food, anorexia to fluids, vomiting, diarrhea, and difficult in swallowing) in percentage of 77%, 69%, 52%, 41%, and 40% respectively. Disorientation / confusion was associated with hyponatremia (in percentage of 91.5%, 84.4%, and 75.5% respectively) and hypocalcemia ((in percentage of 85.7%, 83.3%, and 94.1% respectively); Nausea and slurred speech were associated with hypokalemia in percentages of 70% and 50%; 61.1% and 38.7%; and 61.5% and 39% respectively. Conclusion: the studied patients had many risk factors that altered their recovery and so, their prognosis. Recommendations: Continuous assessment and monitoring for patients undergoing chemotherapy; early detection and prevention of oncological emergencies; provision of lifesaving and immediate interventions to prevent further deteriorations; Establishment of rehabilitation programs for prevention of/ minimizing oncologic emergencies; and provision with written instructional guidelines about side effects of chemotherapy and when to seek medical interventions.
