Question

Head Injury: Priority Finding to Report for a Brain Tumor ( please fill every box!! including safety consideration!!)

ACTIVE LEARNING TEMPLATE System Disorder STUDENT NAME DISORDER/DISEASE PROCESS REVIEW MODULE CHAPTER Alterations in Health (Diagnosis) Pathophysiology Related to Client Problem Health Promotion and Disease Prevention ASSESSMENT SAFETY CONSIDERATIONS Risk Factors Expected Findings Laboratory Tests Diagnostic Procedures PATIENT-CENTERED CARE Complications Nursing Care Medications Client Education Therapeutic Procedures Interprofessional Care

Answer 1

Brain tumor is a massvor growth of abnormal cells in your brain

Alterations in health (Diagnosis)

• Onset of new pattern of headaches
• It becomes more frequent and severe
• Unexplained nausea and vomiting
• Vision problems such as blurred vision, double vision
• Difficulty with balance
• Gradual loss of sensation
• Sometimes seizure

Pathophysiology related to client problem

Brain tumor can form in brain cells or it can begin elsewhere and can  spread to anywhere.

As the tumor grows, it creates pressure on and changes the function surrounding brain tissue, which causes signs and symptoms such as headaches, nausea and sensation problems.

When tumor cells metastasis to regional tissues, it may spread to other organs like lungs , liver etc.

Health promotion and disease prevention

• Brains tumors are sometimes dangerous. Early detection and treatment is the key.
• While watching those above symptoms, please consult doctor. Treatment should not be skipped even if you feel better, sometimes it may recur again
• After treatment, diagnostic test should be carried to determine further extension or metastasis of earlier lesions
• Lifestyle modification is important

Risk factors

• Age and Race

Older people, African- American

• Family history

5-10% cancers are hereditary

• Exposure to certain chemicals or radiation
• Metastasis from lung, breast, lower GIT, pancreas, kidney and skin

Expected findings

• Presence morning headache become frequent and severe
• Vision changes
• Gradual loss of sensation
• Seizures
• Sometimes balance problems.
• If metastasis occurs, symptoms may according to the organ to which it had matastasis

Laboratory tests

• Hormones and blood tests

Some tumors such as pituitary tumors, can produce hormones that are detected in the blood

• Biopsy

Tissue samples taken for examination under a microscope

Diagnostic procedures

• Imaging techniques- CT, MRI, PET scan etc
• Lumbar puncture

It can identify infection, inflammation and cancer cells in the CSF

Safety consideration

• Care the patient not to develop complications
• Alwys be sure about the safety of the patient,
• Side rails should be locked to prevent Patient from falling
• Seizure medication should be always kept ready at the patient bedside
• If unconscious patients, frewuent position change is mandatory to avoid pressure sores.
• Passive ROM exercise to prevent immobility
• Check for symptoms of elevated ICP
• Check GCS score frequently

Patient centred care

Nursing care

• Instruct patients and retivess the importance of undergoing dignostic test and other procedures
• Monitor vital signs frequently
• Assess the neurological ststus
• Assess for symptoms of complications such as elevated ICP.
• Elevate bed end up to 30°
• Institute seizure precautions

If patients undergo surgery.,

Preoperative management

• Assess the neurological status,finds any deterioration,notify the physician
• Monitor vital signs
• Reassure the patients and telatives and alleviate their anxiety and tension about surgery
• Seek consent from the patient or relative for the procedure ​​​​​​

post operative management

• Vital signs monitoring
• Post operative cerebral edemapeaks between 48 and 60 hours of surgery
• Maintain dkin integrity, change position frequenly
• Maintain head level at 30°
• Give passive ROM exercise
• Institute seizure precaution at patient bedside
• Follow accurate input- Output chart
• Assess and have a note on drain at surgical site for color, appearances etc
• Prevent pulmonary complications associate with with bed rest
• Communicate patient always while performing care.

Medication

• ​​​​​​Drugs called corticosteroid , to reduce brain edema associated with cancerous lesions
• Anti seizure medications

Therapeutic procedures

• Surgery -if the brain tumor is located at place, accessible for an operation, the surgeon Will remove the rumor
• RadiatiRadiation-Uses high energy beams, such as X rays, or protons, to kill tumor cells
• Radio surgery - it uses multiple beams of radiation to give highly focuses from of radiation to kill tumor cells in a very small area
• Chemotherapy-Use of drugs to kill tumors
• Rehabilitation after treatment - physical therapy, occupational therapy, speech therapy,

Complication

• Increased ICP
• hemorrhagic stroke
• Metastais to other body parts
• Cerebral Hemorrhage
• Deterioration mental status
• Cerebral hernia, produced sudden vision loss, unconsciousness and paralysis

Client education

• ​​​​​​Instructor the patient to frequently assess the symptoms, which may indicate recurrence
• Follow medication as prescribed by the doctor
• Frequently undergo diagnostic test for further development of cancerous ledions
• Avoid exposure to hazardous chemicals and radiation
• Follow balanced diet and physical activities

Interprofessional care

• Monitor patients keenly whether sny symptoms of complications arise.
• Stict asepsis to be followed while caring patients underwent surgical management
• Communicate every changed of recovery or worsening of situation to the medical team immediately
• Give good patient education
• Follow good therapeutic communication, always explain "what are going to do".