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tumors and neuro

QuestionAnswer
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