Ch 9 Brain Tumors

Question 1

What are the types of brain tumors

Answer 1

Malignant gliomas ( neuralgial cells)
Benign meningiomas ( meninges)
Pituitary adenomas 
Acoustic neuromas ( acoustic cranial nerve)

Question 2

What are supratentorial tumors

Answer 2

Tumors that occur in the cerebral hemispheres above the tectorial cerebelli.

Question 3

What are infratentorial tumors

Answer 3

Tumors that occur below the tentorium cerebelli such as tumors of the brain stem and cerebellum

Question 4

What do brain tumors do

Answer 4

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.

Question 5

What brain tumors are assoc with a high mortality rate

Answer 5

Malignant brain tumors

Question 6

What brain tumors rarely metastasize outside the brain

Answer 6

Primary brain tumors

Question 7

Cranial metastatic lesions most commonly metastasize from where

Answer 7

Breast, kidney, gastrointestinal tract cancers

Question 8

Do benign brain tumors metastasize

Answer 8

They do not metastasize

Question 9

Where do benign brain tumors develop from

Answer 9

Benign brain tumors develop from the meninges or cranial nerves.

Question 10

In what ways do benign brain tumors cause damage

Answer 10

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

Question 11

Are there routine screening procedures to detect brain tumors

Answer 11

No

Question 12

What are risk factors for brain tumors

Answer 12

Genetics
Environmental agents
Exposure to ionizing radiation 
Exposure to electromagnetic fields
Previous head injury

Question 13

What are assessment findings of brain tumors

Answer 13

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

Question 14

What are manifestations specific to supratentorial brain tumors

Answer 14

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

Question 15

What are manifestations specific to infratentorial brain tumors

Answer 15

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.

Question 16

What meds are used to treat headaches as a result of brain tumors

Answer 16

Non opioid analgesics

Opioid medications are avoided because they tend to decrease the clients level of consciousness

Question 17

What meds are used to reduce cerebral edema related to brain tumors

Answer 17

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.

Question 18

What meds are used to control or prevent seizure disorders in brain tumors

Answer 18

Anticonvulsant medications ….. There are several anti epileptic meds used to treat specific seizure disorders

Question 19

H2 antagonist medications are used to treat what

Answer 19

Are used to decrease the acid content of the stomach reducing the risk of stress ulcers

Question 20

When are H2 receptor antagonists typically administered

Answer 20

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

Question 21

Why may nausea with or without visiting be present in brain tumors

Answer 21

It may be present as a result of the increased intracranial pressure, the site of the tumor or the treatment required

Question 22

Craniotomy

Answer 22

Complete or partial resection of brain tumor through surgical opening in the skull

Question 23

What are complications of a brain tumor

Answer 23

SIADH

DIABETES INSIPIDUS

Question 24

What is SIADH

Answer 24

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

Question 25

What is treatment of SIADH

Answer 25

Fluid restriction | Administration of oral demeclocyline and treatment of hyponatremia

Question 26

If SIADH is present, what may the client complain of

Answer 26

Disorientation, headache, and or vomiting

Question 27

If SIADH is severe or left untreated, what may occur

Answer 27

Seizures and or coma

Question 28

What is diabetes insipidus

Answer 28

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

Question 29

What is treatment of diabetes insipidus

Answer 29

Massive fluid replacement Careful attention to laboratory values Replacement of essential nutrients as indicated

Question 30

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?

Answer 30

Following a craniotomy, a nurse should monitor for increased intracranial pressure, the development of hydrocephalus, and seizures.

Question 31

What is a use of dexamethosone

Answer 31

It is given to prevent cerebral edema

Question 32

What is ondansetron administered for

Answer 32

Manage nausea

Question 33

What is phenytoin administered for

Answer 33

Prevention of seizures

Question 34

Wha are some expected findings of increased intracranial pressure

Answer 34

Disoriented to time and place Restlessness and irritability Unequal pupils Headache

Question 35

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?

Answer 35

It is given to reduce swelling of the brain You may notice weight gain It can cause you to retain fluids.

Question 36

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

Answer 36

It is limited to brain tissue.