4 oncological and degenerative neurological disorders

Question 1

ONCOLOGICAL DISORDERS OF THE

BRAIN

Answer 1

Primary brain tumours

Secondary tumours

Question 2

Primary brain tumours

Answer 2

begin in the brain tissue.

Question 3

Types of primary brain tumours

Answer 3

 Gliomas
 Meningiomas
 Acoustic neuromas
 Pineocytoma
 Pituary adenomas
 Angiomas

Question 4

GLIOMAS

Answer 4

Type of tumour that starts in the glial cells of the brain or the spine.

Question 5

BRAIN TUMOURS

CLINICAL MANIFESTATIONS

Answer 5

 Raised intracranial pressure
 Headache
 Vomiting
 Visual disturbance
 Hemiparesis
 Seizures
 Mental status changes

Question 6

BRAIN TUMOURS

ASSESSMENT AND DIAGNOSTIC FINDINGS

Answer 6

 CT scan
 MRI
 PET scan
 EEG
 Biopsy
 Lumbar puncture

Question 7

BRAIN TUMOURS

MANAGEMENT

Answer 7

Dependant on the type, location, severity and accessibility of the tumour
Medical management
Surgical management

Question 8

Medical management

Answer 8

Chemotherapy- destroys cancer cells
Radiation- decreases the incidence of recurrence
Brachytherapy- surgical implantation of radiation sourcesto deliver
high doses at a short distance
Corticosteroids- before or after treatment to reduce cerebral oedema
and promote recovery

Question 9

Surgical management

Answer 9

Remove or destroy the entire tumour

Question 10

NURSING MANAGEMENT

Answer 10

Neurological exam
 Monitoring vital signs
 Monitoring ICP
 Reorientation
 Patient function: self-care ability, movement, walking, speech, vision, dealing
with seizures
 Symptoms that may cause distress to the patient: pain, respiratory
symptoms, bowel and bladder function, sleep, skin integrity, fluid balance
and temperature regulation
 Nutritional status and dietary history
 Family coping and family process

Question 11

BRAIN TUMOURS

POST OP MANAGEMENT

Answer 11

 Reducing cerebral oedema
 Relieving pain
 Seizure prevention
 ICP Monitoring, EVD
 Airway management, gas exchange
 Respiratory status
 Oxygenation, etCO2 monitoring
 BSL
 GCS, LOC, pupillary and motor responses
 Temperature
 Bone flap obs, monitoring for bleeding
 Managing fluid and electrolyte disturbance

Question 12

SPINAL CORD TUMOURS types

Answer 12

Intramedullary

Extramedullary

Question 13

Intramedullary

Answer 13

within the cord

Question 14

Extramedullary

Answer 14

Outside the dural membrane

Question 15

SPINAL CORD TUMOURS symptoms

Answer 15

pain, weakness and loss of motor function, loss

of reflexes, loss of sensation

Question 16

PARKINSON’S DISEASE

Answer 16

Slow progressive neurological movement disorder
Associated with decreased levels of dopamine due to destruction of
cells in the basal ganglia; this effects the neurotransmission of
impulses

Question 17

Clinical manifestations: PARKINSON’S DISEASE

Answer 17

 Tremor
 Rigidity
 Bradykinesia
 Postural instability

Question 18

PARKINSON’S DISEASE

MEDICAL MANAGEMENT

Answer 18

There is no cure for Parkinson’s disease though there is medical and surgical
options for symptom management

Question 19

PARKINSON’S DISEASE

ASSESSMENT

Answer 19

 Focus on the degree of disability and function of the patient including ADLs
and functional abilities
 Assess patient’s quality of speech, loss of facial expression, swallowing
deficits, tremors, slowness of movement, weakness forwards posture,
rigidity, evidence of mental slowness and confusion
 Medications and responses to medications
 Fall risk assessment
 Emotional responses and individual coping
 Family processes and coping
 Home care and education needs
 Manifestations and potential complications related to the specific disorder

Question 20

PARKINSON’S DISEASE

NURSING INTERVENTION

Answer 20

 Improving mobility
 Enhancing self-care activities
 Improving bowel elimination
 Improving nutrition
 Enhancing swallowing
 Encouraging the use of assistive device
 Improving communication
 Supporting coping abilities
 Education

Question 21

MUSCULAR DYSTROPHY complications

Answer 21

spinal deformity, compromised pulmonary function,
gastrointestinal function (bowels), falls, speech issues, drooling, aspiration,
grief. Patients usually remain cognitively intact while body wastes away

Question 22

MUSCULAR DYSTROPHY Treatment

Answer 22

supportive care and preventing complications in absence of a
cure ( eg: individualised exercise program to prevent muscle tightness,
contractures and atrophy

Question 23

Medication for Parkinson

Answer 23

Mao - b inhibitors 
Dopamine precussurs
Dopamin agonist
Comt inhibitors
Anticholinergics

Question 24

Muscular dystrophy

Answer 24

A mucle disorder where there is weakening of the voluntary muscles and skeletal

Question 25

Secondary brain tumour

Answer 25

Cause when cancer ftom other oarts of the body spread to the brain