Week 10 - Brain Tumours and Abscesses Flashcards

1
Q

what are 4 types of brain tumours

A
  • primary
  • secondary
  • benign (encapsulated)
  • malignant (invasive)
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2
Q

what is a primary brain tumour

A
  • arises from tissues inside the brain
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3
Q

what is a secondary brain tumour

A
  • results from malignant neoplasm/tumour elsewhere
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4
Q

what are clinical manifestations of brain tumours (7)

A
  • HA (dull)
  • S&S of IICP
  • seizures
  • NV
  • cognitive problems
  • mood problems
  • personality changes

*depend on location of tumour)

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5
Q

what is included in collab care for brain tumour (6)

A
  • meds
  • ventricular shunts
  • surgery
  • radiation (internal, external)
  • chemo
  • nursing care for IICP
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6
Q

what med if used for brain tumour? what effect does it have

A
  • corticosteroids ex. dexamethsone

- decreases edema surrounding the tumour

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7
Q

what is a ventricular shunt

A
  • drains CSF from ventricles to R atrium or peritoneum
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8
Q

what surgery may be done for brain tumours? (3)

A
  • surgery to debulk or remove mas
  • craniotomy
  • stereotactic radiosurgery (high dose radiation precisely delivered)
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9
Q

what is a brain abscess

A
  • accumulation of pus within the brain tissue
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10
Q

what can a brain abscess result in?

A
  • local or systemic infection
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11
Q

what are the primary causes of brain abcess (2)

A
  • strep
  • staph aureus
    ex. ear, tooth, jaw, or sinus infection/surgery
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12
Q

what is used as a diagnostic for brain abscess

A
  • CT scan
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13
Q

what are S&S of brain abscess (8)

A
  • similar to meningitis & encephalitis
  • HA
  • fever
  • nausea
  • confusion
  • drowsiness
  • seizures
  • focal symptoms
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14
Q

describe collab care/treatment for brain abscess (3)

A
  • antibiotic therapy long term (>6 weeks)
  • surgery to drain or remove abcess
  • nursing care for IICP
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15
Q

describe the process of a craniotomy (4)

A
  1. remove bone flap
  2. remove clot, tumor, or fix problem
  3. establish drain
  4. re-attach bone flap (later time, not urgent)
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16
Q

what is a safety consideration with a craniotomy

A
  • do not turn pt on the side where there is no bone
17
Q

what is the overall goal of post-op care for craniotomy

A
  • foster independence to the highest degree possible
18
Q

where will post-op care be completed for craniotomy

A
  • in ICU or stepdown for close monitoring
19
Q

what is included in post-op care for craniotomy (9)

A
  • monitor/treat IICP
  • maintain CPP
  • prevent, assess, and treat any complications
  • infection prevention
  • care of dressing to head
  • pain & nausea control
  • nutrition
  • bloodwork
  • med admin
20
Q

what are potential complications of post-op craniotomy (5)

A
  • pneumonia
  • stress gastric ulcer
  • DVT/PE
  • constipation
  • fluid and electrolyte balance
21
Q

how long are sutures/staples in place for post-op craniotomy

A
  • 7-10 days
22
Q

at what point is rehab potential determined

A
  • once cerebral edema and IICP subside
23
Q

what specialists may be consulted post-op craniotomy

A
  • physio
  • ot
    etc.
24
Q

describe the rehab process post-craniotomy

A
  • long process: weeks, months, years
  • the younger the person is, the better the recovery will be
  • may never be the “same person/personality” as before
25
Q

what are burr holes often used for

A
  • subdural hematoma
26
Q

what are burr holes (5)

A

involves:

  • incision site over left frontal area
  • drilling of hole at skull (one or two holes drilled)
  • opening of dura
  • evacuation of subdural fluid (hematoma)
  • placement of drain tube ( can be in for few days)
27
Q

what stereotactic methods may be used for brain tumour (2)

A
  • stereotactic radiosurgery

- stereotactic Bx/surgery

28
Q

what is stereotactic radiosurgery

A
  • use of high dose of radiation (Gamma knife) to destroy brain tumor
29
Q

how is the pt’s head held still during stereotactic mthods

A
  • by a stereotactic frame
30
Q

what are stereotactic bx/surgery used for (3)

A
  • brain biopsies
  • small tumours
  • abscesses
31
Q

describe stereotactic bx/surgery

A
  • apparatus and computer used to find precise area of the brain
  • surgeon enters w fine instruments
32
Q

decsribe the pt during stereotactic methods

A
  • pt may be aware during the surgery

- may assist w brain mapping by speaking, moving, etc. to indicate to their surgeon where they are touching

33
Q

a nursing diagnosis r/t cranial surgery is acute pain. what nursing interventions may be done for this (4)

A
  • assess pain
  • admin pain meds as ordered
  • use pain control measures before pain becomes severe
  • position pt comfortably
34
Q

a nursing diagnosis r/t cranial surgery is risk for infection. what nursing interventions may be done for this (9)

A
  • maintain aseptic technique during surgical procedures
  • change IV and central line sites according to guidelines
  • hand hygiene before and after each pt care activity
  • encourage rest so nutrition is used for healing purposed
  • monitor for S&S of infection
  • monitor WBC
  • inspect surgical incisions for signs of infection
  • change craniotomy dressings as ordered w strict sterile technique
  • obtain blood and wound for cultures