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NUR202 > Brain Tumors > Flashcards

Brain Tumors Flashcards

1
Q

tumors located within cerebral hemispheres

A

supratentorial tumors

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2
Q

tumors located beneath fold of dura mater

A

infratentorial tumors

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3
Q

2 types of cells within nervous system

A

neurons and neuroglial cells

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4
Q

responsibility of neurons

A

nerve impulse conduction

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5
Q

responsibility of neuroglial cells

A

support, nourishment, protection of neurons

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6
Q

4 types of neuroglial cells

A

astrocytes, oligodendroglia, ependymal, microglia

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7
Q

most common benign tumor

A

meningiomas

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8
Q

benign tumor, young middle aged adults, loss of hair, visual disturbances, hypopituitary signs, DI, infertility, visual field defects, headaches

A

pituitary tumors

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9
Q

tumor from sheath of Schwann cell in cranial nerve VIII, also called cerebellar pontine angle tumors – hearing loss, tinnitus, dizziness, vertigo — hard to remove

A

acoustic neuromas

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10
Q

grade – tissue is benign, cells look nearly like normal brain cells, grow slowly

A

grade I

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11
Q

grade – tissue is malignant, look less like normal cells

A

grade II

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12
Q

malignant tissue has cells looking very different than normal brain cells, actively growing (anaplastic)

A

grade III

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13
Q

has malignant cells looking most abnormal grow quickly

A

grade IV

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14
Q

acoustic neuroma, choroid plexus papilloma, meningioma, pituitary adenoma, astrocytoma grade I, chondroma, craniopharyngioma, hemoangioblastoma

A

benign tumors

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15
Q

astrocytoma grade IV, oligodendroglioma, ependymoma, medulloblastoma, glioma, lymphoma

A

malignant tumors

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16
Q

cerebral edema, brain tissue inflammation, increased ICP, neuro deficits, hydrocephalus, pituitary dysfunction

A

complications of cerebral tumors

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17
Q

cause of brain tumors

A

unknown

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18
Q

headache more severe on awakening, N+V, visual sx, seizures or convulsions, facial numbness tingling, balance loss or dizziness, weakness or paralysis, difficulty thinking speaking articulating, change in mentation or personality, papilledema

A

sx of brain tumor

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19
Q

tumor that results in paralysis, seizures, memory loss, cognitive impairment, language impairment, or vision problems

A

supratentorial tumors

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20
Q

tumor result in ataxia, ANS dysfunction, vomiting, drooling, hearing loss, vision impairment

A

infratentorial tumors

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21
Q

common brain tumors

A

cerebral and brainstem

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22
Q

scans used to dx brain tumor

A

CT, MRI, skull films

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23
Q

monitored by CT and MRI periodically

A

small benign tumors

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24
Q

managed by chemotherapy, radiation, and or surgery

A

malignant tumors

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25
Q

interstitial chemotherapy

A

disk-shaped drug wafer – carmustine

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26
Q

given for headache and fever

A

codeine, acetaminophen

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27
Q

given to control cerebral edema

A

dexamethasone

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28
Q

given to prevent seizure activity

A

phenytoin

29
Q

given to decrease gastric secretion – prevent stress ulcers

A

PPI

30
Q

types of stereotactic radiosurgery

A

modified linear accelerator, particle accelerator, isotope seeds implanted (brachytherapy)

31
Q

using accelerated x-rays

A

modified linear accelerator

32
Q

particle accelerator using beams of protons

A

cyclotron

33
Q

isotope seed implanted in tumor

A

brachytherapy

34
Q

SRS procedure using single high dose of ionized radiation to focus multiple beams of gamma to destroy intracranial lesions selectively

A

gamma knife

35
Q

incision cranium to remove tumor, improve symptoms related to lesion, or debulk tumor size

A

craniotomy

36
Q

concerns of patient going to have craniotomy

A

increased neuro deficits and self-image (shaved head)

37
Q

pt should not have pre-op craniotomy at least 5 days before

A

alcohol, tobacco, ACs, NSAIDs

38
Q

pt should be at least 8 hours before craniotomy

A

NPO

39
Q

minimally invasive surgery

A

removes small tumors (trans-nasal approach with endoscopy for pituitary tumors)

40
Q

uses burr holes and local anesthetic for easily reached tumors

A

stereotactic surgery

41
Q

focus for post-op craniotomy care

A

monitor changes in status and prevent or minimize complications – increased ICP

42
Q

how often to assess neuro and vital signs after craniotomy

A

every 15-30 mins for first 4-6 hours, then every hour

43
Q

what to immediately document after craniotomy

A

new neuro deficits, decreased LOC, motor weakness, paralysis, change in speech, decreased sensation, reduced pupil reaction to light, personality changes

44
Q

managing periorybital edema and ecchymosis of one of both eyes – craniotomy

A

cold compresses reduces swelling, irrigate eye with warm saline or artificial tears

45
Q

fluid restriction amount for first 24 hours post craniotomy

A

1500 mL if pituitary involvement

46
Q

prevention of VTE post craniotomy

A

repositioning and deep breathing every 2 hours

47
Q

management of supratentorial surgery

A

elevated HOB 30 degrees for venous drainage from head

48
Q

position for infratentorial craniotomy

A

flat and side-lying, alternating sides every 2 hours for 24-48 hours – prevents pressure on neck area incision site and internal tumor excision site form higher cerebral structures

49
Q

infratentorial needs NPO for 24 hours post craniotomy bc…

A

edema around medulla and lower cranial nerves can cause vomiting and aspiration

50
Q

how often to check dressing for signs of drainage post craniotomy

A

1-2 hours – mark areas of drainage once per shift for baseline comparison – 50 mL/8hr – watch for hypovolemic shock

51
Q

how often to measure drainage post craniotomy

A

every 8 hours – record amount and color – 30-50 mL normal amount

52
Q

why hyponatremia post craniotomy?

A

fld volume overload, SIADH, steroid admin

53
Q

symptoms of hyponatremia?

A

weakness, change in LOC, confusion

54
Q

causes of hypernatremia?

A

meningitis, dehydration, DI

55
Q

signs of hypernatremia?

A

muscle weakness, restlessness, extreme thirst, dry mouth, decreased urinary output, thick lung secretions, hypotension (dehydration assoc.) – late is seizures

56
Q

what is considered if voiding large amounts of dilute urine with increasing serum osmolarity and lyte concentration?

A

DI

57
Q

what to do before, during, and after suctioning patient on vent after craniotomy

A

hyperoxygenate

58
Q

major complications of supratentorial surgery

A

increased ICP from cerebral edema, hydrocephalus, hemorrhage

59
Q

symptoms of increasing ICP

A

severe headache, deteriorating LOC, restlessness, irritability, dilated or pinpoint pupils slow reaction or nonreactive to light

60
Q

caused by obstruction of normal CSF pathway from edema, expanding lesion (hematoma), or blood in subarachnoid space

A

hydrocephalus

61
Q

sx of slowly progressing hydrocephalus

A

headache, decreased LOC, irritability, blurred vision, urinary incontinence

62
Q

major complication of shunting procedure

A

subdural hematoma from tearing of bridging veins

63
Q

sx of subdural and intracranial hemorrhage

A

severe headache, rapid decrease in LOC, progressive neuro deficits, herniation syndromes (tissue shift down)

64
Q

what is used to treat intracranial hemorrhage

A

osmotic diuretics, ICP monitoring, CPP management

65
Q

respiratory complications of craniotomy

A

atelectasis, pneumonia, neurogenic pulmonary edema

66
Q

how to prevent atelectasis and pneumonia post-op

A

turn patient frequently and encourage frequent deep breaths hourly, humidified air, incentive spirometry

67
Q

life-threatening complication of traumatic brain injury, tumors, and brain surgery, sx same of acute pulmonary edema – non cardiac related – terrible survival rate

A

neurogenic pulmonary edema

68
Q

results from surgery, wound infection, CSF leak, contamination during surgery

A

meningitis

NUR202 (8 decks)

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