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Adult Health l > Brain Tumors, TPH, SAH > Flashcards

Brain Tumors, TPH, SAH Flashcards

1
Q

Primary brain tumors originate within the ___

A

CNS

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2
Q

Secondary tumors from ___ in other parts of the body

A

Metastasis ( the spread of a cancer or other disease from one organ or part of the body to another not directly connected with it)

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3
Q

Classification of brain tumors

A

Benign (It does not invade nearby tissue or spread to other parts of the body the way cancer can) or malignant (cancerous and are made up of cells that grow out of control)

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4
Q

Classification (location) of brain tumors

A

Supratentorial- located within the cerebral hemispheres.

Infratentorial- the area composed of the cerebellum and brainstem.

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5
Q

Classification (cellular origin) of brain tumors

A

Astrocytes, oligodendroglia, ependymal, microglia (neuroglial cells that provide nourishment, support and protections for neurons.

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6
Q

Classification (anatomic location) of brain tumors)

A

Meningioma , Acoustic neuroma

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7
Q

Most common benign tumors that arise from the covering of the brain (meninges)

A

Meningioma (visual disturbances, loss of body hair, diabetes insipidus, infertility, visual fields defects and headaches)

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8
Q

Arise from the sheath of Schwann cells in peripheral portion of cranial nerve VIII (cerebellar pontine angle tumors)

A

Acoustic neuroma (hearling loss, tinnitus, dizziness or vertigo)

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9
Q

Nonsurgical management of brain tumors

A 
Radiation therapy
Chemotherapy 
(Orally, IV, intra-arterially or intrathecally
Direct drug delivery post-surgically)
Analgesics
Dexamethasone
Phenytoin
Pantoprazole (protonix)
Stereotactic radiosurgery
(Gamma knife, CyperKnife)
(Real Child Are Devine People Plus Saints)
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10
Q

Stereotactic radiosurgery procedure that uses a single high dose of ionized radiation to focus multiple beams of gamma radiation to destroy intracranial lesions selectively without damaging healthy tissues

A

Gamma knife treatment

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11
Q

Surgical removal of a section of bone (bone flap) from the skull for the purpose of operating on the underlying tissues, usually the brain.

A

Craniotomy

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12
Q

Nursing intervention post craniotomy (fluid balance)

A

Observe for DI- A disorder of salt and water metabolism marked by intense thirst and heavy urination or SIADH-A condition in which high levels of a hormone cause the body to retain water.

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13
Q

Nursing intervention post craniotomy (incision)

A

Assess site
Observe presence or absence of bone flap
Observe for CSF leak

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14
Q

Nursing intervention post craniotomy (ICP/ decrease ICP)

A

Ventriculostomy -neurosurgical procedure that involves creating a hole (“ostomy”) within a cerebral ventricle for drainage. It is done by surgically penetrating the skull, dura mater, and brain such that the ventricle of the brain is accessed.

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15
Q

Nursing intervention post craniotomy (avoid activities that increase ICP)

A

Stool softeners to avoid valsalva
Antiemetics for N/V
Antipyretics/cooling blanket for fever
Proper positioning: (Avoid extreme neck or hip flexion and maintain the head in a neutral midline position)

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16
Q

Nursing intervention post craniotomy (others)

A

DVT prophylaxis
Stress ulcers: (Cushing Stress Ulcer)
Pneumonia: (High risk aspiration altered LOC)

17
Q

Nursing intervention post craniotomy (eye care)

A

periorbitial edema, treated with cold compressions to decrease swelling, irrigate effected eye with warm saline or artificial tears to improve discomfort

18
Q

Commonly used surgical approach for pituitary region masses

A

Transsphenoidal hypophysectomy (TPH)

19
Q

Transsphenoidal hypophysectomy (TPH) uses a ___ ___ approach

A

Nasal cavity

20
Q

Transsphenoidal hypophysectomy (TPH) abtains a ___ tissue graft

A

Adipose

21
Q

Transsphenoidal hypophysectomy (TPH) nursing interventions for nasal packing

A

no nose blowing, breathe through mouth, check nose for CSF leak ( can cause meningitis)

22
Q

Transsphenoidal hypophysectomy (TPH) complications include

A

air embolism
CSF leak (meningitis)
Diabetes Insipidus
Visual disturbances

23
Q

Transsphenoidal hypophysectomy (TPH) post operative care include

A 
HOB increase to 35-40°
Hourly UOP (0.5-1 mL/kg/hr)
Monitor electrolytes
Avoid any straining (Antiemetics for nausea
Do NOT blow your nose)
Monitor for visual disturbances
24
Q

Types of cerebral aneurysms

A

Berry- on the anterior communicating artery of the brain, outpouching affecting only a distinct portion of the artery
Fusiform- diffuse dilation affecting the entire circumference of the artery

25
Q

Assessment findings of a Subarachnoid Hemorrhage from cerebral aneurysm

A

Severe, sudden HA
Brief loss of consciousness
N/V
Kernig’s Sign, Brudzinski’s Sign, Photophobia

26
Q

Diagnostics of a Subarachnoid Hemorrhage from cerebral aneurysm

A

CT
Lumbar Puncture
Cerebral angiogram

27
Q

Pre operative management goals of a Subarachnoid Hemorrhage from cerebral aneurysm

A

Medical Emergency
Direct effects of initial hemorrhage
Craniotomy with aneurysm clipping within 48 hours post bleed
Flush out blood basal cistern (reservoir of CSF around cistern and base of brain and circle of Willis, prevent vasospasms)

28
Q

Pre operative precautions of a Subarachnoid Hemorrhage from cerebral aneurysm

A 
BP control, keep low
(To prevent rebleeding)
Bedrest
Dark, quiet environment
Stool softeners, no straining
No restraints, keep calm
HOB ↑ 35- 45° degrees at all times
DVT precautions
Educate family to keep calm environment
29
Q

Post operative management of a Subarachnoid Hemorrhage from cerebral aneurysm

A

Complications can lead to death

Cerebral vasospasm

30
Q

Treatment post op of a Subarachnoid Hemorrhage from cerebral aneurysm

A

HHH after clipping

31
Q

HHH stands for

A

Hypertensive (increase BP and CO with vasoactive drugs)
Hypervolemic- volume expanders (albumin)
Hemodilution- Fluid

32
Q

SAH complications

A 
Hyponatremia (Isotonic fluids= NS or LR)
Rebleeding (Sudden onset HA, N&V, 
Increased BP
Respiratory changes)
Hydrocephalus
(Ventriculostomy – temporary measure
Shunt – permanent measure)
Seizures
(Prophylactic anticonvulsant medication)
33
Q

Purulent infection of brain

Frontal and temporal most common

A

Brain abscess

34
Q

Findings of a brain abscess by be ___ at presentation

A

atypical

35
Q

Treatment of a brain abscess

A

Antibiotics and surgical intervention (drain)

36
Q

Symptoms of a brain abscess

A

Headache, fever, pain, motor deficits, ataxia, aphasia, sensory impairments, seizure activity, visual field changes

Adult Health l (9 decks)

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