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S. is a 46-year-old female with metastatic breast cancer. She is currently off cycle for chemotherapy and

generally is feeling well. Today, however, she presents feeling acutely unwell. She says that she has had coldlike symptoms over the last few days, including cough, nasal congestion, headache, and a hoarse voice in the mornings. Today she became acutely concerned because she feels as though her face and even shoulders look swollen and a bit discolored—bluish. She denies any nausea or vomiting but admits to feeling generally fatigued; she attributes it to her cancer. Recognizing the likely diagnosis, the AGACNP knows that treatment will likely include:


B. Surgery

C. Fibrinolytics

D. Expansile stents

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