Ch 9 Brain Tumors Flashcards
What are the types of brain tumors
Malignant gliomas ( neuralgial cells) Benign meningiomas ( meninges) Pituitary adenomas Acoustic neuromas ( acoustic cranial nerve)
What are supratentorial tumors
Tumors that occur in the cerebral hemispheres above the tectorial cerebelli.
What are infratentorial tumors
Tumors that occur below the tentorium cerebelli such as tumors of the brain stem and cerebellum
What do brain tumors do
They apply pressure to surrounding brain tissue, resulting in decreased outflow of CSF, increased intracranial pressure, cerebral edema, and neurological deficits. Tumors that involve the pituitary gland may cause endocrine dysfunction.
What brain tumors are assoc with a high mortality rate
Malignant brain tumors
What brain tumors rarely metastasize outside the brain
Primary brain tumors
Cranial metastatic lesions most commonly metastasize from where
Breast, kidney, gastrointestinal tract cancers
Do benign brain tumors metastasize
They do not metastasize
Where do benign brain tumors develop from
Benign brain tumors develop from the meninges or cranial nerves.
In what ways do benign brain tumors cause damage
These tumors have distinct boundaries and cause damage either by the pressure they excert within the cranial cavity and or by impairing the function of the cranial nerve
Are there routine screening procedures to detect brain tumors
No
What are risk factors for brain tumors
Genetics Environmental agents Exposure to ionizing radiation Exposure to electromagnetic fields Previous head injury
What are assessment findings of brain tumors
Dysarthria ( poor articulation of speech)
Dysphagia ( difficulty swallowing)
Positive Romberg sign
Positive babinski sign
Vertigo
Hemiparesis
Cranial nerve dysfunction ( inability to discriminate sounds, loss of gag reflex, loss of blink response
What are manifestations specific to supratentorial brain tumors
Severe headaches ( worse upon weakening but improving over time)
Visual changes
Seizures, loss of voluntary movement or the inability to control movement
Change in cognitive function ( memory loss, language impairment)
Change in personality
Nausea with or without vomiting
What are manifestations specific to infratentorial brain tumors
Hearing loss or ringing in the ear Facial drooping Difficulty swallowing Nystagmus, crossed eyes or decreased vision Autonomic nervous system dysfunction Ataxia or clumsy movements Hemiparesis Cranial nerve dysfunction ( inability to discriminate sounds, loss of gag reflex, loss of blink response.
What meds are used to treat headaches as a result of brain tumors
Non opioid analgesics
Opioid medications are avoided because they tend to decrease the clients level of consciousness
What meds are used to reduce cerebral edema related to brain tumors
Corticosteroid meds quickly reduce cerebral edema and may be repaidly administered to maximize effectiveness
Chronic administration is used to control cerebral edema assoc with the presence or treatment of benign or malignant brain tumors.
What meds are used to control or prevent seizure disorders in brain tumors
Anticonvulsant medications ….. There are several anti epileptic meds used to treat specific seizure disorders
H2 antagonist medications are used to treat what
Are used to decrease the acid content of the stomach reducing the risk of stress ulcers
When are H2 receptor antagonists typically administered
During acute or stressful periods, such as after surgery, at the initiation of chemotherapy, or during the first several radiation therapy treatments….. The impact of these treatments, together with the necessity of corticosteroids places the client at risk for stress ulcers
Why may nausea with or without visiting be present in brain tumors
It may be present as a result of the increased intracranial pressure, the site of the tumor or the treatment required
Craniotomy
Complete or partial resection of brain tumor through surgical opening in the skull
What are complications of a brain tumor
SIADH
DIABETES INSIPIDUS
What is SIADH
A condition where fluid is retained as a result of an overproduction of vasopressin or anti diuretic hormone from the posterior pituitary gland. This condition occurs when the hypothalamus has been damaged and can no longer regular enthe release of ADH
What is treatment of SIADH
Fluid restriction
Administration of oral demeclocyline and treatment of hyponatremia
If SIADH is present, what may the client complain of
Disorientation, headache, and or vomiting
If SIADH is severe or left untreated, what may occur
Seizures and or coma
What is diabetes insipidus
A condition where large amounts of urine are excreted as a result of deficiency of ADH from the posterior pituitary gland
The condition occurs when the hypothalamus has been damaged and can no longer regulate the release of ADH
What is treatment of diabetes insipidus
Massive fluid replacement
Careful attention to laboratory values
Replacement of essential nutrients as indicated
A nurse is caring for a client who is having surgery for the removal of an encapsulated acoustic tumor. What potential complications should the nurse monitor for post operatively?
Following a craniotomy, a nurse should monitor for increased intracranial pressure, the development of hydrocephalus, and seizures.
What is a use of dexamethosone
It is given to prevent cerebral edema
What is ondansetron administered for
Manage nausea
What is phenytoin administered for
Prevention of seizures
Wha are some expected findings of increased intracranial pressure
Disoriented to time and place
Restlessness and irritability
Unequal pupils
Headache
A nurse is reviewing a prescription for dexamethosone ( Decadron) for a patient who has an expanding brain tumor. What are appropriate statements by the nurse to make?
It is given to reduce swelling of the brain
You may notice weight gain
It can cause you to retain fluids.
A nurse is caring for a client who has a benign brain tumor. The client asks the nurse If he can expect this same type of tumor to occur in other areas of his body. What is an appropriate statement by the nurse
It is limited to brain tissue.
