MONITORING PATIENTS THAT HAVE RECEIVED ALL-TRANS RETINOIC ACID (ATRA) TREATMENT DIAGNOSED WITH RETINOIC ACID SYNDROME.

2.50
Hdl Handle:
http://hdl.handle.net/10755/165097
Category:
Abstract
Type:
Presentation
Title:
MONITORING PATIENTS THAT HAVE RECEIVED ALL-TRANS RETINOIC ACID (ATRA) TREATMENT DIAGNOSED WITH RETINOIC ACID SYNDROME.
Author(s):
Privitere, Lisa; Nokic, Merima
Author Details:
Lisa Privitere, RN OCN, Head Nurse, Roswell Park Cancer Institute, Buffalo, New York, USA, email: lisa.privitere@roswellpark.org; Merima Nokic, RN
Abstract:
Current data has shown a distinct complex of symptoms that has been reported among patients receiving all-trans retinoic acid (ATRA) therapy for acute promyelocytic leukemia. Among patients with appropriate cytogenic profile, ATRA has demonstrated efficacy as an alternative to cytoxic chemotherapy, by inducing the differentiation of malignant cells into phenotypically mature myeloid cells. ATRA has produced complete remission in a large proportion of patients treated reaching 90%. With consistent use of ATRA and ongoing growth of patients on treatment- retinoic acid syndrome has been identified. The syndrome consists of fever, dyspnea, weight gain, pulmonary infiltrates, pleural or pericardial effusions, episodic hypotension, renal dysfunction and leukocytosis. Less likely but always associated with a higher mortality rate is pulmonary hemorrhage. To reduce potential length of stay, mechanical ventilation, and other complications, preventing retinoic acid syndrome is critical to decreased mortality, improved quality of life and cost efficiency. To improve our potential outcomes we identified the following interventions: 1) Implementing in-services on RA syndrome on direct care givers and patients (early side effects) 2) Monitoring closely input and output, vital signs, weights, shortness of breath, blood results (complete blood count, comprehensive metabolic panel) 3) Evaluating patient status closely, checking renal function, pulmonary infiltrates, including diagnostic such as X-ray, ECHO (ruling out possible cardiac tamponade) 4) Cessation of ATRA for moderate or severe retinoic acid syndrome 5) Rigorous exclusion of superimposed infection 6) Diuresing patient as tolerated by hemodynamic and renal status Retinoic acid syndrome is associated with substantial morbidity and a reported mortality rate as high as nine percent. However, the majority of patients have made a complete recovery if this syndrome is recognized and treated early and ATRA is withdrawn. The Oncology nurse is able to manage a patient receiving ATRA if knowledgeable about potential complications. This syndrome is almost completely reversible if the nurse at the bedside is able to recognize, report clinical findings and understand the actions needed to prevent further harm. This presentation will provide the Oncology Nurse with the information to improve nursing care of patients receiving ATRA.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2007
Conference Name:
32nd Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
Las Vegas, Nevada, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleMONITORING PATIENTS THAT HAVE RECEIVED ALL-TRANS RETINOIC ACID (ATRA) TREATMENT DIAGNOSED WITH RETINOIC ACID SYNDROME.en_GB
dc.contributor.authorPrivitere, Lisaen_US
dc.contributor.authorNokic, Merimaen_US
dc.author.detailsLisa Privitere, RN OCN, Head Nurse, Roswell Park Cancer Institute, Buffalo, New York, USA, email: lisa.privitere@roswellpark.org; Merima Nokic, RNen_US
dc.identifier.urihttp://hdl.handle.net/10755/165097-
dc.description.abstractCurrent data has shown a distinct complex of symptoms that has been reported among patients receiving all-trans retinoic acid (ATRA) therapy for acute promyelocytic leukemia. Among patients with appropriate cytogenic profile, ATRA has demonstrated efficacy as an alternative to cytoxic chemotherapy, by inducing the differentiation of malignant cells into phenotypically mature myeloid cells. ATRA has produced complete remission in a large proportion of patients treated reaching 90%. With consistent use of ATRA and ongoing growth of patients on treatment- retinoic acid syndrome has been identified. The syndrome consists of fever, dyspnea, weight gain, pulmonary infiltrates, pleural or pericardial effusions, episodic hypotension, renal dysfunction and leukocytosis. Less likely but always associated with a higher mortality rate is pulmonary hemorrhage. To reduce potential length of stay, mechanical ventilation, and other complications, preventing retinoic acid syndrome is critical to decreased mortality, improved quality of life and cost efficiency. To improve our potential outcomes we identified the following interventions: 1) Implementing in-services on RA syndrome on direct care givers and patients (early side effects) 2) Monitoring closely input and output, vital signs, weights, shortness of breath, blood results (complete blood count, comprehensive metabolic panel) 3) Evaluating patient status closely, checking renal function, pulmonary infiltrates, including diagnostic such as X-ray, ECHO (ruling out possible cardiac tamponade) 4) Cessation of ATRA for moderate or severe retinoic acid syndrome 5) Rigorous exclusion of superimposed infection 6) Diuresing patient as tolerated by hemodynamic and renal status Retinoic acid syndrome is associated with substantial morbidity and a reported mortality rate as high as nine percent. However, the majority of patients have made a complete recovery if this syndrome is recognized and treated early and ATRA is withdrawn. The Oncology nurse is able to manage a patient receiving ATRA if knowledgeable about potential complications. This syndrome is almost completely reversible if the nurse at the bedside is able to recognize, report clinical findings and understand the actions needed to prevent further harm. This presentation will provide the Oncology Nurse with the information to improve nursing care of patients receiving ATRA.en_GB
dc.date.available2011-10-27T12:12:28Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:12:28Z-
dc.conference.date2007en_US
dc.conference.name32nd Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationLas Vegas, Nevada, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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