The nurse is reviewing data collected on a group of patients being treated for cancer. Which patient or patients' cancer type, pathophysiology,
and symptoms should the nurse identify as being consistent with the oncological emergency of superior vena cava syndrome?
1. Patient C
2. Patient D
3. Patient A only
4. Patients A and B
Correct Answer: 4
The superior vena cava can be compressed by mediastinal tumors or adjacent thoracic tumors. The most common cause is small-cell or squamous-cell lung cancers. Occasionally the problem is caused by thrombus around a central venous catheter that then plugs up the vena cava, resulting in obstruction and backup of the blood flowing into the superior vena cava. Obstruction of the venous system causes increased venous pressure, venous stasis, and engorgement of veins that are drained by the superior vena cava. Signs and symptoms may develop slowly; facial, periorbital, and arm edema are early signs. As the problem progresses, respiratory distress, dyspnea, cyanosis, tachypnea, and altered consciousness and neurologic deficits may occur.
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