Nursing Action: - Maintain suction equipment in the client’s room - Initial oral intake should be provided by an RN so that appropriate interventions can be taken if choking occurs. - Test the client’s gag reflex. If present let patient take a small sip of water to determine is choking occurs. - Provide the prescribed diet, and observe closely for choking. - A client with dysphasia usually tolerates thick liquids better than thin liquids. - IF the client exhibits some difficulty managing food or fluids, speech therapy should conduct a swallowing evaluation. Phase III: - Discharge and referrals - Visiting nurse - Continued Rehabilitation
Brain Tumor (p.539): Where does a primary malignant brain tumor originate? - From neuroglia tissue and rarely metastasize outside the brain What are secondary brain tumors? - Lesions that are metastases from a primary cancer located elsewhere in the body. Where are Cranial metastatic lesions most commonly from? - Breast, Kidney, and GI tract cancers Where do Benign Brain tumors develop? - From meninges or cranial nerves and do not metastasize. - Have distinct boundaries and cause damage by the pressure they exert within the cranial cavity and/or by impairing the function of the crainial nerve. What are brain tumors that occur in the cerebral hemispheres above the tentorium cerebelli classified as? - Supratentorial tumors What are brain tumors below the tentorium cerebelli, such as tumors of the brainstem and cerebellum classified as? - Infretentorial Tumors What are the risk factors of brain tumors? - The cause is unknown, but several risk factors have been identified - Genetics - Environmental agents - Exposure to ionizing radiation - Exposure to electromagnetic field - Previous head injury Neoplasms within the confines of the skull are space-occupying lesions, and thus create problems of increasing ICP by compressing adjacent tissues Signs and Symptoms: - Dysarthria Dysphagia Positive Romberg sign Positive Babinski's sign Vertigo Hemiparesis
Cranial nerve dysfunction (inability to discriminate sounds, loss of gag reflex, loss of blink response Seizures LAB tests: - CBC and differential to rule out anemia or malnutrition - Blood alcohol and toxicology screen to rule out these as causes of altered physical findings - TB and HIV screenings is social conditions warrants Surgical Interventions - Craniotomy – Complete or partial resection of brain through surgical opening in the skull - Nursing Action Pre-operative: - Instruct the client to discontinued aspirin products at least 72 hours prior to the procedures - Medication should be administered as prescribed. The provider can prescribe an antianxiety medication or muscle relaxant. Postoperative - Provide routine postoperative care to prevent complications - Keep the client’s head elevated 30O and place in neutral position.
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- Spring '16
- Med surg, Seizure, Seizures