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NUR202 > Brain Tumors > Flashcards

Brain Tumors Flashcards

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1
Q

tumors located within cerebral hemispheres

A

supratentorial tumors

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2
Q

tumors located beneath fold of dura mater

A

infratentorial tumors

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3
Q

2 types of cells within nervous system

A

neurons and neuroglial cells

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4
Q

responsibility of neurons

A

nerve impulse conduction

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5
Q

responsibility of neuroglial cells

A

support, nourishment, protection of neurons

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6
Q

4 types of neuroglial cells

A

astrocytes, oligodendroglia, ependymal, microglia

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7
Q

most common benign tumor

A

meningiomas

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8
Q

benign tumor, young middle aged adults, loss of hair, visual disturbances, hypopituitary signs, DI, infertility, visual field defects, headaches

A

pituitary tumors

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9
Q

tumor from sheath of Schwann cell in cranial nerve VIII, also called cerebellar pontine angle tumors – hearing loss, tinnitus, dizziness, vertigo — hard to remove

A

acoustic neuromas

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10
Q

grade – tissue is benign, cells look nearly like normal brain cells, grow slowly

A

grade I

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11
Q

grade – tissue is malignant, look less like normal cells

A

grade II

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12
Q

malignant tissue has cells looking very different than normal brain cells, actively growing (anaplastic)

A

grade III

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13
Q

has malignant cells looking most abnormal grow quickly

A

grade IV

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14
Q

acoustic neuroma, choroid plexus papilloma, meningioma, pituitary adenoma, astrocytoma grade I, chondroma, craniopharyngioma, hemoangioblastoma

A

benign tumors

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15
Q

astrocytoma grade IV, oligodendroglioma, ependymoma, medulloblastoma, glioma, lymphoma

A

malignant tumors

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16
Q

cerebral edema, brain tissue inflammation, increased ICP, neuro deficits, hydrocephalus, pituitary dysfunction

A

complications of cerebral tumors

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17
Q

cause of brain tumors

A

unknown

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18
Q

headache more severe on awakening, N+V, visual sx, seizures or convulsions, facial numbness tingling, balance loss or dizziness, weakness or paralysis, difficulty thinking speaking articulating, change in mentation or personality, papilledema

A

sx of brain tumor

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19
Q

tumor that results in paralysis, seizures, memory loss, cognitive impairment, language impairment, or vision problems

A

supratentorial tumors

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20
Q

tumor result in ataxia, ANS dysfunction, vomiting, drooling, hearing loss, vision impairment

A

infratentorial tumors

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21
Q

common brain tumors

A

cerebral and brainstem

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22
Q

scans used to dx brain tumor

A

CT, MRI, skull films

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23
Q

monitored by CT and MRI periodically

A

small benign tumors

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24
Q

managed by chemotherapy, radiation, and or surgery

A

malignant tumors

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25
interstitial chemotherapy
disk-shaped drug wafer -- carmustine
26
given for headache and fever
codeine, acetaminophen
27
given to control cerebral edema
dexamethasone
28
given to prevent seizure activity
phenytoin
29
given to decrease gastric secretion -- prevent stress ulcers
PPI
30
types of stereotactic radiosurgery
modified linear accelerator, particle accelerator, isotope seeds implanted (brachytherapy)
31
using accelerated x-rays
modified linear accelerator
32
particle accelerator using beams of protons
cyclotron
33
isotope seed implanted in tumor
brachytherapy
34
SRS procedure using single high dose of ionized radiation to focus multiple beams of gamma to destroy intracranial lesions selectively
gamma knife
35
incision cranium to remove tumor, improve symptoms related to lesion, or debulk tumor size
craniotomy
36
concerns of patient going to have craniotomy
increased neuro deficits and self-image (shaved head)
37
pt should not have pre-op craniotomy at least 5 days before
alcohol, tobacco, ACs, NSAIDs
38
pt should be at least 8 hours before craniotomy
NPO
39
minimally invasive surgery
removes small tumors (trans-nasal approach with endoscopy for pituitary tumors)
40
uses burr holes and local anesthetic for easily reached tumors
stereotactic surgery
41
focus for post-op craniotomy care
monitor changes in status and prevent or minimize complications -- increased ICP
42
how often to assess neuro and vital signs after craniotomy
every 15-30 mins for first 4-6 hours, then every hour
43
what to immediately document after craniotomy
new neuro deficits, decreased LOC, motor weakness, paralysis, change in speech, decreased sensation, reduced pupil reaction to light, personality changes
44
managing periorybital edema and ecchymosis of one of both eyes -- craniotomy
cold compresses reduces swelling, irrigate eye with warm saline or artificial tears
45
fluid restriction amount for first 24 hours post craniotomy
1500 mL if pituitary involvement
46
prevention of VTE post craniotomy
repositioning and deep breathing every 2 hours
47
management of supratentorial surgery
elevated HOB 30 degrees for venous drainage from head
48
position for infratentorial craniotomy
flat and side-lying, alternating sides every 2 hours for 24-48 hours -- prevents pressure on neck area incision site and internal tumor excision site form higher cerebral structures
49
infratentorial needs NPO for 24 hours post craniotomy bc...
edema around medulla and lower cranial nerves can cause vomiting and aspiration
50
how often to check dressing for signs of drainage post craniotomy
1-2 hours -- mark areas of drainage once per shift for baseline comparison -- 50 mL/8hr -- watch for hypovolemic shock
51
how often to measure drainage post craniotomy
every 8 hours -- record amount and color -- 30-50 mL normal amount
52
why hyponatremia post craniotomy?
fld volume overload, SIADH, steroid admin
53
symptoms of hyponatremia?
weakness, change in LOC, confusion
54
causes of hypernatremia?
meningitis, dehydration, DI
55
signs of hypernatremia?
muscle weakness, restlessness, extreme thirst, dry mouth, decreased urinary output, thick lung secretions, hypotension (dehydration assoc.) -- late is seizures
56
what is considered if voiding large amounts of dilute urine with increasing serum osmolarity and lyte concentration?
DI
57
what to do before, during, and after suctioning patient on vent after craniotomy
hyperoxygenate
58
major complications of supratentorial surgery
increased ICP from cerebral edema, hydrocephalus, hemorrhage
59
symptoms of increasing ICP
severe headache, deteriorating LOC, restlessness, irritability, dilated or pinpoint pupils slow reaction or nonreactive to light
60
caused by obstruction of normal CSF pathway from edema, expanding lesion (hematoma), or blood in subarachnoid space
hydrocephalus
61
sx of slowly progressing hydrocephalus
headache, decreased LOC, irritability, blurred vision, urinary incontinence
62
major complication of shunting procedure
subdural hematoma from tearing of bridging veins
63
sx of subdural and intracranial hemorrhage
severe headache, rapid decrease in LOC, progressive neuro deficits, herniation syndromes (tissue shift down)
64
what is used to treat intracranial hemorrhage
osmotic diuretics, ICP monitoring, CPP management
65
respiratory complications of craniotomy
atelectasis, pneumonia, neurogenic pulmonary edema
66
how to prevent atelectasis and pneumonia post-op
turn patient frequently and encourage frequent deep breaths hourly, humidified air, incentive spirometry
67
life-threatening complication of traumatic brain injury, tumors, and brain surgery, sx same of acute pulmonary edema -- non cardiac related -- terrible survival rate
neurogenic pulmonary edema
68
results from surgery, wound infection, CSF leak, contamination during surgery
meningitis

NUR202 (8 decks)

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