A brain tumor is an overgrowth of cells that creates a mass of tissue within the brain. As it grows, this compresses the brain tissue, causing symptoms ranging in severity from minor headaches to brain death. Symptoms will vary based on the size and location of the tumor.
May be benign (non-cancerous) or malignant (cancerous). Malignant tumors may be primary, meaning they originate in the brain itself (glioblastoma, meningioma, etc.), or they could be secondary. Secondary tumors originate elsewhere in the body and metastasize to the brain. There are quite a few things that put patients at risk for brain tumors, including head injuries, radiation exposure, environmental exposure, and genetics.
Prevent severe complications (seizures, strokes), minimize and manage symptoms, successful treatment, and removal without residual effects.
Brain Tumors Nursing Care Plan
- Memory Loss
- Mood/Personality Changes
- Sensory Losses
- Loss of balance
- Altered LOC
- Vision loss
- Elevated temp
- Respiratory distress
- Cushing’s Triad
- Diabetes Insipidus if Pituitary Damage present
Nursing Interventions and Rationales
- Administer antiepileptic drugs
Brain tumors can put pressure on neurons within the brain and cause electrical activity to overreact. Patients are at high risk for seizures. Antiepileptic drugs increase the seizure threshold.
- Administer other medication therapy as ordered
Chemotherapy and/or radiation may be given to shrink the tumor. Corticosteroids are given to decrease inflammation around the tumor. Antiemetics are given to decrease nausea and prevent vomiting if possible.
- Place the patient in seizure precautions
Side rails should be padded to prevent injury, suction should be available in case of aspiration during a seizure.
- Frequent neuro checks (q1-2h)
Neurological changes related to increasing ICP may be subtle or may occur rapidly. Frequent detailed neuro checks allow changes to be recognized quickly so that interventions can be initiated.
- Perform interventions to minimize ICP:
- Maintain HOB 30-45°
- Decrease stimuli
- Avoid valsalva maneuvers
- Maintain HOB 30-45°
- HOB < 30 = increased blood flow to brain → Increased ICP
- HOB > 45 = increased intrathoracic pressure → decreased venous outflow from brain → increased ICP
- Decrease stimuli
- Agitation or stress can cause increased ICP
- Avoid Valsalva maneuvers
- Coughing or bearing down can cause increased ICP
- Monitor respiratory status & protect airway as needed
If there is brainstem involvement, patients may experience difficulty regulating their breathing or protecting their airway. The airway may also be compromised if the patient has a seizure.
- Prepare patient for possible craniotomy
A craniotomy may be performed to remove the tumor or to biopsy it. It may also be performed to place an ICP monitoring device.
- Educate patients on the importance of medication compliance.
Antiepileptic drugs have a narrow therapeutic window. Missing even one dose can cause a seizure.
Cornell Note-Taking System Instructions:
- Record: During the lecture, use the note-taking column to record the lecture using telegraphic sentences.
- Questions: As soon after class as possible, formulate questions based onthe notes in the right-hand column. Writing questions helps to clarifymeanings, reveal relationships, establish continuity, and strengthenmemory. Also, the writing of questions sets up a perfect stage for exam-studying later.
- Recite: Cover the note-taking column with a sheet of paper. Then, looking at the questions or cue-words in the question and cue column only, say aloud, in your own words, the answers to the questions, facts, or ideas indicated by the cue-words.
- Reflect: Reflect on the material by asking yourself questions, for example: “What’s the significance of these facts? What principle are they based on? How can I apply them? How do they fit in with what I already know? What’s beyond them?
- Review: Spend at least ten minutes every week reviewing all your previous notes. If you do, you’ll retain a great deal for current use, as well as, for the exam.
For more information, visit www.nursing.com/cornell