Turkiye Klinikleri Journal of Nursing Sciences

.: REVIEW
Multipl Miyelom Hastalarında Onkolojik Acillere Yönelik Kanıt Temelli Tıbbi Öneriler ve Hemşirelik Yönetimi: Geleneksel Derleme
Evidence-Based Medical Recommendations and Nursing Management for Oncological Emergencies in Patients with Multiple Myelom: Traditional Review
Tuba METİNa, Özlem UĞURb
aKütahya Sağlık Bilimleri Üniversitesi Simav Sağlık Hizmetleri Meslek Yüksekokulu, Tıbbi Hizmetler ve Teknikerler Bölümü, Kütahya, Türkiye
bDokuz Eylül Üniversitesi Hemşirelik Fakültesi, Onkoloji Hemşireliği ABD, İzmir, Türkiye
Turkiye Klinikleri J Nurs Sci. 2022;14(3):924-40
doi: 10.5336/nurses.2021-87793
Article Language: TR
Full Text
ÖZET
 Kanser, dünya çapında ölüm nedenleri arasında 2. sırada yer alan ve insidansı her geçen gün artan önemli bir sağlık sorunudur. Hematolojik kanserler arasında yer alan ve yaklaşık olarak tüm malignitelerin %10'unu oluşturan multipl miyelom, anormal monoklonal protein sentezi, immunoglobulin ve hafif serbest zincir artışı ile karakterize progresif neoplastik plazma hücrelerinin bir hastalığıdır. Kemik iliğinde gelişen anormal monoklonal protein hücreleri, çoklu organ yetersizliğime neden olmakta ve hastaların yaşam kalitesini olumsuz etkilemektedir. Miyelom tanısı alan ve tedavi gören kişiler metabolik, kardiyojenik, nörolojik olaylar ve enfeksiyon gibi yaşamlarını tehdit eden bazı komplikasyonların gelişmesi yönünden risk altındadır. Onkolojik aciller olarak adlandırılan bu durum, bilinen bir malignitenin ilerlemesinden kaynaklanan veya önceden teşhis edilmemiş bir malignitenin ilk belirtisi olarak ortaya çıkan geniş bir hastalık yelpazesini temsil etmektedir. Multipl miyelom nedeniyle hastalarda gelişen acil durumlar; mekanik, metabolik ve hematolojik olarak ortaya çıkmaktadır. En sık görülen mekanik aciller arasında, %7,8 oranında spinal kord basısı ve %39,2'sinde vertebral kırık yer almaktadır. Metabolik aciller arasında en sık %54 oranında hafif serbest zincir artışına bağlı akut renal yetersizlik, %30 oranında hiperkalsemi ve %18,1'inde tümör lizis sendromu görülmektedir. Hematolojik aciller arasında ise %72 oranında anemi, %39-%50 oranında nötropeni ve %18'inde trombositopeni yer almaktadır. Multipl miyelom nedeniyle ortaya çıkan acil durumların yıkıcı etkilerinin bilinmesi, erken tanımlanabilmesi ve etkin yönetiminin sağlanması hastaların yaşam kalitesinin iyileşmesi ve sağkalım süresinin artması açısından büyük önem taşımaktadır. Bu nedenle bu derlemede, multipl miyelom hastalarında onkolojik acil durumlara ilişkin kanıt temelli tıbbi önerilerin sunulması ve multipl miyelom hastalarında onkolojik acil durumlarda hemşirelik yönetiminin ele alınması amaçlanmaktadır.

Anahtar Kelimeler: Multipl miyelom; onkoloji hemşireliği; aciller; kanıta dayalı hemşirelik
ABSTRACT
 Cancer is an important health problem that ranks second among the causes of death worldwide and its incidence is increasing day by day. Multiple myeloma, which is among the hematological cancers and constitutes approximately 10% of all malignancies, is a disease of progressive neoplastic plasma cells characterized by abnormal monoclonal protein synthesis, immunoglobulin and light free chain increase. Abnormal monoclonal protein cells developing in the bone marrow cause multi-organ failure and adversely affect the quality of life of patients. People diagnosed and treated for myeloma are at risk of developing some life-threatening complications such as metabolic, cardiogenic, neurological events and infection. These socalled oncological emergencies represent a wide spectrum of diseases arising from the progression of a known malignancy or presenting as the first manifestation of a previously undiagnosed malignancy. Emergencies developing in patients due to multiple myeloma occur mechanically, metabolically and hematologically. Among the most common mechanical emergencies, spinal cord compression in 7.8% and vertebral fractures in 39.2% are included. Among the metabolic emergencies, acute renal failure due to light free chain increase in 54%, hypercalcemia in 30% and tumor lysis syndrome in 18.1% are observed most frequently. Hematological emergencies include anemia in 72%, neutropenia in 39%-50%, and thrombocytopenia in 18%. Knowing the devastating effects of emergencies caused by multiple myeloma, early identification and effective management are of great importance in terms of improving the quality of life of patients and increasing survival time. Therefore, in this review, it is aimed to present evidence-based medical recommendations regarding oncological emergencies in multiple myeloma patients and to discuss nursing management in oncological emergencies in multiple myeloma patients.

Keywords: Multiple myeloma; oncology nursing; emergencies; evidence-based nursing
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4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com