Page 1303 - Saunders Comprehensive Review For NCLEX-RN

sodium intake as prescribed.
b. As prescribed, administer an antagonist
to antidiuretic hormone.
c. Monitor serum sodium levels.
d. Treat the underlying cause with
chemotherapy or radiation to achieve
tumor regression.
C. Spinal cord compression
1. Description
a. Spinal cord compression occurs when a
tumor directly enters the spinal cord or
when the vertebral column collapses
from tumor entry, impinging on the
spinal cord.
b. Spinal cord compression causes back
pain, usually before neurological
deficits occur.
c. Neurological deficits relate to the spinal
level of compression and include
numbness; tingling; loss of urethral,
vaginal, and rectal sensation; and
muscle weakness.
2. Interventions
a. Early recognition: Assess for back pain
and neurological deficits.
b. Administer high-dose corticosteroids to
reduce swelling around the spinal cord
and relieve symptoms.
c. Prepare the client for immediate
radiation and/or chemotherapy to
reduce the size of the tumor and
relieve compression.
d. Surgery may need to be performed to
remove the tumor and relieve the
pressure on the spinal cord.
e. Instruct the client in the use of neck or
back braces if they are prescribed.
D. Hypercalcemia
1. Description
a. Hypercalcemia is a late manifestation of
extensive malignancy that occurs most
often with bone metastasis, when the
bone releases calcium into the
bloodstream.
b. Decreased physical mobility contributes
to or worsens hypercalcemia.
c. Early signs include fatigue, anorexia,
nausea, vomiting, constipation, and

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