types of brain tumors

Question 1

brain tumors are classified by what?

Answer 1

histology

can be malignant or benign

Question 2

gliomas

Answer 2

include astrocytomas- spreads by infiltrating surrounding tissues
start in the glial cells

Question 3

meningiomas

Answer 3

tumors of the menigies 
encapsulated 
slow growing 
benign 
symptoms are due to compression rather than invasion

Question 4

acoustic neuromas

Answer 4

tumor of the 8th cranial nerve
vertigo, tinnitus, loss of hearing, slow growing internal meatus
may be benign- removed or radiotherapy

Question 5

pituitary adenomas

Answer 5

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

Question 6

metastatic tumors

Answer 6

secondary to other cancers

Question 7

pituitary hormones

Answer 7

GH, ACTH, TSH, FSH, LH, ADH, oxytocin and cortisol

Question 8

clinical manifestations of brain tumors

Answer 8

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)

Question 9

manifestations of icp

Answer 9

decrease hr
inc bp 
decrease rr
stupor to coma 
monitor for cheynne strokes

Question 10

ICP monitoring

Answer 10

a drain may be placed, when icp raises, csf is drained, when it returns to normal, close drain

Question 11

co2 effects on vessels in the brain

Answer 11

the more the co2 the more vasodilitation occurs

Question 12

normal icp

Answer 12

10-20

Question 13

if csf shifts and icp keeps rising what will happen?

Answer 13

brain stem herniation

Question 14

coma

Answer 14

unconsciousness, unarousable, unresponsiveness

Question 15

akinetic mutism

Answer 15

unresponsiveness to environment

sometimes open eyes

Question 16

persistent vegetative state

Answer 16

devoid of cognitive function but has sleep wake cycles

Question 17

locked in syndrome

Answer 17

inability to move or respond except for eye movement, due to leison on pons

Question 18

trx of brain tumors

Answer 18

surgery- craniotomy, transphenoidal, stereotactic procedures
radiation (gamma-external), (brachytherapy) (stereotactic)
chemotherapy- must cross blood brain barrier

Question 19

supportive drugs for brain tumors

Answer 19

steroids
mannitol
phenobarbital

Question 20

assessment and interventions for brain tumors

Answer 20

pain management of HA
elevate HOB (decrease icp and prevent aspiration)
antiemetics
prophylactic seizure meds
motor function (pt/ot)
speech eval (alternatives for communication)

Question 21

Diabetes insipidus

Answer 21

no release of ADH 
excessive fluid loss (decreased specific gravity) 
dehydration 
electrolyte imbalance 
Management: 
IV fluids (3% NS) 
Vasopressin (dDVAP)
*draw bloods before intervening*

Question 22

Syndrome of inappropriate antidiruetic hormone

Answer 22

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

Question 23

maintaining an airway

Answer 23

frequent lung assessments 
repositioning 
hob 30 degress 
lateral or semi prone 
suctioning and oral hygiene

Question 24

nursing process

Answer 24

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

Question 25

complications

Answer 25

DVT, PE
CSF leak
new signs and symptoms- cancer may have spread