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tumors and neuro
| Question | Answer |
|---|---|
| Two-thirds childhood brain tumors are | infratentorial;The infratentorial region contains the cerebellum, while the supratentorial region contains the cerebrum. The infratentorial dura is innervated by nerves from C1-C3. |
| Occur all ages, peaks of incidence in | early childhood, 5-7 |
| What are the BRAIN TUMORS Classification | Primary or Secondary Location Benign or Malignant Cellular Differentiation Tissue Type – Histological |
| _______astrocytoma or glioblastoma mutiformea is a type of tumor that starts in the brain or spine. It is called a glioma because it arises from glial cells. The most common site is the brain | Gliomas;A brain glioma=headaches, n/v, seizures.cranial nerve d/o as a result of ICP.optic nerve=visual loss. Spinal cord gliomas= pain, weakness, or numbness in the extremities. Gliomas do not mets by the bloodstream, but can spread via the csf |
| are a diverse set of tumors arising from the meninges,are the most common primary brain tumor,usually benign, | Meningiomas; Changes in vision, such as seeing double or blurriness Headaches that worsen with time |
| is a slow-growing tumor of the nerve that connects the ear to the brain. This nerve is called the vestibular cochlear nerve.is not cancerous (benign), | acoustic neuroma; Abnormal feeling of movement (vertigo) Hearing loss in the affected ear that makes it hard to hear conversations Ringing (tinnitus) in the affected ear |
| are noncancerous (benign),cause excessive production of hormones or produce lower levels of hormones,noncancerous growths (adenomas) | Pituitary tumors; Headache Vision loss, particularly loss of peripheral vision Nausea and vomiting Symptoms of pituitary hormone deficiency Fatigue Weakness Cold intolerance Constipation |
| Papilledema Headaches Vomiting Change in mental status Seizures IICP Focal symptoms | SIGNS AND SYMPTOMS BRAIN TUMORS |
| Name some treatment for tumors | Surgery Radiation Gamma Knife Radiation Chemotherapy |
| temozolomide (Temodar) – first oral agent nitrosoureas (BCNU) Gliadel wafers Bebacizumab (Avastin) – targeted therapy Intrathecal administration with Ommaya reservoir | Chemotherapy |
| Noninvasive form of radiation treatment Intersection of 201 beams of cobalt-60 Treats brain tumors & AVM’s Stereotactic frame to skull | GAMMA KNIFE |
| POTENTIAL COMPLICATIONS | IICP Hemorrhage Respiratory Neurogenic Pulmonary Edema Seizures Infection Alteration in ADH regulation* |
| A & P REVIEW OF ADH | Regulates body’s water balance Hormone regulated by hypothalamus Stored in post. pituitary Released into circulation & acts on kidney’s distal tubules & collecting ducts Increases permeability to water More water reabsorbed |
| caused by a lack of ADH | Diabetes insipidus (DI) |
| excessive release of ADH from the posterior pituitary gland.The result is hyponatremia & sometimes fluid overload.usually found in pt's diag with pneumonia,brain tumors,head trauma,strokes,meningitis,encephalitis,or small-cell carcinoma of the lung. | SIADH |
| UO: 200 mL/hr* SG: 1.005 or < Serum Na+: 145 or > | DI or decrease ADH |
| <30 mL/hr for 2 hr >1.025 Decreased; S/S if Na+ <125* | SIADH or increased ADH |
| Plasma osmolality increased (Plasma osmolarity measures the body's electrolyte-water balance)Treat with: often transient problem, replace fluid vasopressin if needed | DI or decrease ADH |
| Decreased osmolality (Plasma osmolarity measures the body's electrolyte-water balance) Treat with: fluid restriction, Na+ replacement, assess for fluid overload | SIADH or increased ADH |
| Primary hyponatremia Decreased fluid volume and decreased sodium Treated by fluid and sodium replacement | Cerebral Salt Wasting (CSW) |
| Selected Nursing Diagnoses | Decreased intracranial adaptive capacity R/T postoperative edema, hemorrhage Ineffective tissue perfusion: cerebral R/T cerebral edema, decreased cerebral perfusion, IICP Acute pain R/T the surgical procedure |
| POST OPERATIVE NEUROLOGIC MANAGEMENT FOCUSES ON | Cerebral edema management Cerebral perfusion promotion Fluid balance Neurologic monitoring Respiratory status: gas exchange |
| Temodar used to treat glioma causes | myelosuppression;Before giving a dose, the absolute neutrophil count should be at least 1500/μL, and the platelet count should be at least 100,000/μL. |
| the most common type of brain tumors | Metastatic brain tumors from a malignant neoplasm elsewhere in the body |
| signs and symptoms include memory deficits, visual disturbances, weakness of right upper and lower extremities, and personality changes. You recognize this as a | a cranial tumor;A frontal lobe tumor may result in hemiplegia, seizures, memory deficit, personality and judgment changes, and visual disturbances. |
| The primary goal of care after cranial surgery is prevention of increased intracranial pressure (ICP), which includes keeping the body | in alignment |
| Fever, severe headache, vomiting, and nuchal rigidity (neck stiffness) are key clinical manifestations of | meningitis; the bacterial form can cause dementia, seizures, deafness, hemiplegia, and hydrocephalus. The viral has full recovery |
| Persons who have close contact with anyone who has bacterial meningitis should | be given prophylactic antibiotic |
| A side effect of Dilantin is.... | gingival hyperplasia (Phenytoin is used to control certain type of seizures, and to treat and prevent seizures that may begin during or after surgery to the brain or nervous system. ) |
| A positive sign of ______in an adult can indicate disease of the brain or spinal cord | Babinski sign (toes curl downward, plantar reflex) |
| Rabies usually is fatal. Management efforts are directed at | preventing the transmission and onset of the disease, and postexposure prophylaxis is administered |
| This usually develops in the first week following a brain insult. Its duration is usually brief (spontaneously resolves in 2-4 wk), although it can last for several months. | Cerebral salt-wasting syndrome |
| Urine specific gravity greater than 1.025 indicate __________, whereas those of less than 1.010 indicate _________. | concentrated urine;dilute urine |
Created by:
troop27
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