Neurosensory: Stroke/Brain tumors
Part # 2 Brain Tumors
A. Pathophysiology/etiology
Primary brain tumors
 Arise from support cells,
neurogilia cells; the
meninges; or blood
vess...
Pathophysiology/etiology
Primary brain tumors
 Grade I and II gilomas (astrocytoma) made up of
astrocytes; are benign, sl...
Pathophysiology/etiology
Metastatic (secondary) brain tumors
 Originate from outside
the brain- lung and breast
most comm...
B. Common manifestations/complications
 Brain tumor symptoms occur due to their ability
to compress or destroy brain tiss...
Common manifestations/complications
Local (anatomical) as interfere with
function
 Frontal lobe: personality changes; ina...
Common manifestations/complications
Local (anatomical)
 Occipital lobe: visual disturbances; visual agnosia
 Temporal lo...
C. Therapeutic interventions
for brain tumors
 Diagnostic tests:
CT/MRI; EEG
 Medications
 Chemotherapy: IV;
intraventr...
Therapeutic interventions
for brain tumors- Surgery
 To remove tumor or for
symptom relief
 Supratentorial- cranial
surg...
Therapeutic interventions for brain tumors
 Radiation therapy
 Used alone or with other therapies
 Gamma Knife- shielde...
D. Nursing assessment specific brain tumors
 Health history: progression of symptoms; other
cancers, disease
 Physical e...
E. Pertinent nursing problems & interventions
 1. Anxiety: brain is the essence of an individual;
individual/family suppo...
Pertinent nursing problems & interventions
 5. Disturbed self-esteem: individual support
 6 Home care: rehabilitation; h...
Nursing Care Plan: A Client with a Brain
Tumor LeMone p. 1397
http://wps.prenhall.com/wps/media/objects/737/755395/brain_
...
Added critical thinking questions:
Nursing Care Plan: A Client with a Brain Tumor
LeMone p. 1394
 1. Where is the frontal...
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  1. 1. Neurosensory: Stroke/Brain tumors Part # 2 Brain Tumors
  2. 2. A. Pathophysiology/etiology Primary brain tumors  Arise from support cells, neurogilia cells; the meninges; or blood vessels  Do not metastasize outside cranium  Cause unknown
  3. 3. Pathophysiology/etiology Primary brain tumors  Grade I and II gilomas (astrocytoma) made up of astrocytes; are benign, slow-growing tumors  Grade II and IV gliomas (glioblastoma Multiforme are invasive and fast-growing  Meningiomas arise from the meninges; slow- growing; benign, encapsulated and compress the brain  Brain tumors may be lethal due to their location
  4. 4. Pathophysiology/etiology Metastatic (secondary) brain tumors  Originate from outside the brain- lung and breast most common sites  Single or multiple tumors within the brain tissue  Becoming more common as individuals with cancer in other parts of the body are living longer
  5. 5. B. Common manifestations/complications  Brain tumor symptoms occur due to their ability to compress or destroy brain tissue  From edema that forms around the tumor  From hemorrhage  From obstruction of CSF flow  General increased intracranial (IICP) symptoms (refer to module # ), headache usually worse in AM
  6. 6. Common manifestations/complications Local (anatomical) as interfere with function  Frontal lobe: personality changes; inappropriate behavior; inability to concentrate; impaired judgment; headache; expressive aphasia if dominant hemisphere; motor weakness or paralysis from motor strip  Parietal lobe: sensory deficits- paresthesia, visual field deficits; contralateral sensory disturbances from sensory strip; loss of interpretation and discrimination for sensing input; perceptual problems
  7. 7. Common manifestations/complications Local (anatomical)  Occipital lobe: visual disturbances; visual agnosia  Temporal lobe: complex partial (psychomotor) seizures; auditory hallucinations; memory problems; Wernicke aphasia if dominant hemisphere  Cerebellum: gait distrubances; balance and coordination problems  Brain stem: cranial nerve dysfunction; vital signs
  8. 8. C. Therapeutic interventions for brain tumors  Diagnostic tests: CT/MRI; EEG  Medications  Chemotherapy: IV; intraventricular (ommaya Reservoir) or by wafer implanted  Corticosteroids to treat brain edema  Anticonvulsants to prevent seizures
  9. 9. Therapeutic interventions for brain tumors- Surgery  To remove tumor or for symptom relief  Supratentorial- cranial surgery above the tentortium (double fold dura between cerebrum & cerebellum)  Infratentorial- surgery below the tentortium  Stereotaxic surgery to localize tumor/remove
  10. 10. Therapeutic interventions for brain tumors  Radiation therapy  Used alone or with other therapies  Gamma Knife- shielded helmet containing cobalt directed to tumor to shrink the tumor  Rehabilitation  Outpatient or in-house  Coping adapting with neuro deficits
  11. 11. D. Nursing assessment specific brain tumors  Health history: progression of symptoms; other cancers, disease  Physical exam  Neuro vital signs  Specific signs of the local functions of different parts of the brain  Similar neuro deficits as the individual with a stroke  Signs of increased intracranial pressure/herniation
  12. 12. E. Pertinent nursing problems & interventions  1. Anxiety: brain is the essence of an individual; individual/family support and education  2. Risk for infection- post crani: assess for CSF leak; meningitis; other infections  3. Ineffective protection post surgery: assess for IICP from cerebral edema or bleeding  4. Acute pain: assess for pain; R/O meningitis as cause for pain; medication; HOB 30 degrees
  13. 13. Pertinent nursing problems & interventions  5. Disturbed self-esteem: individual support  6 Home care: rehabilitation; home evaluation for neuro deficits; support groups
  14. 14. Nursing Care Plan: A Client with a Brain Tumor LeMone p. 1397 http://wps.prenhall.com/wps/media/objects/737/755395/brain_ http://wps.prenhall.com/chet_lemone_medical
  15. 15. Added critical thinking questions: Nursing Care Plan: A Client with a Brain Tumor LeMone p. 1394  1. Where is the frontal lobe and what is its functions?  2. What is the pathophysiology of Clair Langes’ symptoms?  3. Why would the nursing diagnosis of altered cerebral perfusion pressure be important?  4. What type of seizure did Clair have?  5. What are the different types of gliomas?  6. Why does lying in a flat position and coughing increase Clair’s headache?
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