types of brain tumors Flashcards
brain tumors are classified by what?
histology
can be malignant or benign
gliomas
include astrocytomas- spreads by infiltrating surrounding tissues
start in the glial cells
meningiomas
tumors of the menigies encapsulated slow growing benign symptoms are due to compression rather than invasion
acoustic neuromas
tumor of the 8th cranial nerve
vertigo, tinnitus, loss of hearing, slow growing internal meatus
may be benign- removed or radiotherapy
pituitary adenomas
deep in the center of the brain
symptoms develop because of the pressure
hyper or hypofunction of the pituitary gland
surgery or radiation
have mood swings, also pushes on optic nerve, chiasm, frontal lobe
metastatic tumors
secondary to other cancers
pituitary hormones
GH, ACTH, TSH, FSH, LH, ADH, oxytocin and cortisol
clinical manifestations of brain tumors
general neuro symptoms increased icp h/a n/v visual disturbances (papilledema) sezuires- focal or generalized hormonal effects with pituitary adenoma loss of hearing, tinnitus, vertigo (acoustic neuroma)
manifestations of icp
decrease hr inc bp decrease rr stupor to coma monitor for cheynne strokes
ICP monitoring
a drain may be placed, when icp raises, csf is drained, when it returns to normal, close drain
co2 effects on vessels in the brain
the more the co2 the more vasodilitation occurs
normal icp
10-20
if csf shifts and icp keeps rising what will happen?
brain stem herniation
coma
unconsciousness, unarousable, unresponsiveness
akinetic mutism
unresponsiveness to environment
sometimes open eyes
persistent vegetative state
devoid of cognitive function but has sleep wake cycles
locked in syndrome
inability to move or respond except for eye movement, due to leison on pons
trx of brain tumors
surgery- craniotomy, transphenoidal, stereotactic procedures
radiation (gamma-external), (brachytherapy) (stereotactic)
chemotherapy- must cross blood brain barrier
supportive drugs for brain tumors
steroids
mannitol
phenobarbital
assessment and interventions for brain tumors
pain management of HA
elevate HOB (decrease icp and prevent aspiration)
antiemetics
prophylactic seizure meds
motor function (pt/ot)
speech eval (alternatives for communication)
Diabetes insipidus
no release of ADH excessive fluid loss (decreased specific gravity) dehydration electrolyte imbalance Management: IV fluids (3% NS) Vasopressin (dDVAP) *draw bloods before intervening*
Syndrome of inappropriate antidiruetic hormone
too much ADH therefore water is retained
leads to water intoxication (r/t excess thirst)
hyponatremia (water retained, sodium becomes depleted)
Management:
fluid restriction
KCL supplements and increase K in diet
maintaining an airway
frequent lung assessments repositioning hob 30 degress lateral or semi prone suctioning and oral hygiene
nursing process
frequent neuro checks ICP monitoring pain level s/s of seizures ADLS nutritional support patients functional abilities sleep disturbances aspiration precautions foley? to prevent constant t and p and increased icp
complications
DVT, PE
CSF leak
new signs and symptoms- cancer may have spread
