65: Management of patients with oncologic or degenerative neurologic disorders

A client is exhibiting late signs of increased intracranial pressure. Which of the following would the nurse most likely assess? Select all that apply

-Hypertension -Bradycardia -Respiratory depression

A client with a metastatic brain tumor of the frontal lobe experiences a generalized seizure for the first time. The nurse should prepare for what action?

Administration of anticonvulsants

A nurse is planning discharge education for a client who underwent a cervical discectomy. What strategies would the nurse assess that would aid in planning discharge teaching?

Care of the cervical collar

A client with amyotrophic lateral sclerosis (ALS) is being visited by the home health nurse who is creating a care plan. Which of the followin nursing diadnoses is most likely for a client with this condition?

Impaired verbal communication

A client has been admitted to the neurologic unit for the treatment of a newly diagnosed brain tumor. The client has just exhibited seizure activity for the first time. What is the nurse's priority response to this event?

Implement precautions to ensure the client's safety

The clinic nurse is caring for a client with Parkinson disease and notes that the client has been taking levodopa and carbidopa (Sinemet) for 7 years. For what common side effect should the nurse assess this client?

Dyskinesia

A nurse is conducting an assessment of a client who is suspected of having a brain tumor. Assessment reveals reports of headaches, for which the nurse gathers additional information. The nurse determines that these reports support the suspicion of a brain tumor when the client reports that the headache occurs:

Early in the morning

The nurse is planning the care of a client who has been recently diagnosed with a cerebellar tumor. Due to the location of this client's tumor, the nurse should implement measures to prevent what complication?

Falls

A client has just returned to the unit from the pacu after surgery for a tumor within the spine. The client reports pain. When positioning the client for comfort and to reduce injury o the surgical site, the nurse will position the client in what position?

In a flat side-lying position

A nurse is an extended care facility is planning the daily activities of a client with post-polio syndrome. The nurse recognizes the client will best benefit from physical therapy when it is scheduled at what time?

In the morning

An older adult has encouraged the spouse husband to visit their primary provider, stating that concern that spouse many have Parkinson disease. Which description of the sposuse's health and function is most suggestive of Parkinson disease?

Lately he seems to move far more slowly then he ever has in the past

A client with Parkinson disease is experiencing episodes of constipation that are becoming increasingly frequent and severe. The client reports achieving relief for the past few weeks by using over-the-counter laxatives. How should the nurse respond?

Lets explore other options, because laxatives can have side effects and create dependency

A nurse is assessing a client wih an acoustic neuroma who has been recently admitted to an oncology unit. What symptoms is the nurse likely to find during the initial assessment?

Loss of hearing, tinnitus and vertigp

A female client is admitted to the medical unit for evaluation of cerebral metastasis from a primary site. When reviewing the client's history, the nurse would most likely find which site as being the primary site?

Lung

The nurse is caring for a boy who has muscular dystrophy. When planning assistance with the client's ADLs, what goal should the nurse prioritize?

Maximizing the client's level of function

A client diagnosed with cancer of the lung, has just been told the cancer has metastasized to the brain. What change in health status would the nurse attribute to the client's metastatic brain disease?

Personality changes

A client with a new diagnosis of amyotrophic lateral sclerosis (ALS) is overwhelmed by the diagnosis and the known complications of the disease. How can the client best make known their wishes for care as the disease progresses?

Prepare an advance directive

A male client presents at the fee clinic with reports of erectile dysfunction. Upon physical examination, the nurse practiotioner notes the presence of hypogonadism. What diagnosis should the nurse suspect?

Prolactonia

The nurse is caring for a client diagnosed with Parkinson disease has helped prepare a plan of care that would include which goal?

Promoting effective communication

A client has just been diagnosed with Parkinson disease and the nurse is planning the client's subsequent care for the home setting. What nursing diagnosis should the nurse address when educating the client's family?

Risk for injury

A client with Parkinson disease is undergoing a swallowing assessment because the client has recently developed adventitious lung sounds. The client's nutritional needs should be met by what method?

Semisolid food with thick liquids

A client who has been experiencing numerous episodes of unexplained headaches and vomiting has subsequently been referred for testing to rule out a brain tumor. What characteristic of the client's vomiting is most consistent with a brain tumor?

The client's vomiting is unrelated to food intake

A gerontologic nurse is advocating for diagnostic testing of an 81-year-old client who is experiencing personality changes. The nurse is aware of what factor that is known to affect the diagnosis and treatment of brain tumors in older adults?

The effects of the brain tumors are often attributed to the cognitive effects of aging

A client diagnosed with a pituitary adenoma has arrived on the neurologic unit. When planning the client's care, the nurse should be aware that the effects of the tumor will primarily depend on the what variable?

The specific hormones secreted by the tumor

The nurse is caring for a client newly diagnosed with a primary brain tumor. The client asks the nurse where the tumor came from. What would be the nurse's best response?

Your tumor originated from cells within your brain itself

A client newly diagnosed with a cervical disk herniation is receiving health education from the clinic nurse. What conservative management measures should management measures should the nurse teach the client to implement?

sleep on a firm mattress

A client with a brain tumor has begun to exhibit signs of cachexia. What subsequent assessment should the nurse prioritize?

Assessment of nutritional status

A nurse is reading a journal article about brain tumors and the various types that can occur. The nurse demonstrates understanding of the article by identifying which type as being classified as an intracerebral tumor? Select all that apply

-Glioblastoma -Astrocytoma -Medulloblastoma

The nurse is caring for a client with a brain tumor who is experiencing symptoms due to compression and infiltration of normal tissue. The pathophysiologic changes that result can cause what manifestations? Select all that apply

-Increased ICP -Focal neurologic signs -Altered pituitary funciton

A family memeber of a client diagnosed with Huntington disease calls the clinic. The family member is requesting help from the Huntington disease society of America. What kind of help can this client and family receive from this organization? Select all that apply

-Information about this disease -Referral's -Public education

A client with an inoperable brain tumor has been told that the client has a short life expectancy. On what aspects of assessment and care should the home health nurse focus? select all that apply

-Pain control -Management of treatment of complications -Assistance with Self-care -Administration of treatments

A client is diagnosed with an acoustic neuroma. When assessing this client, which manifestation would the nurse expect to find? Select all that apply

-Tinnitus -Vertigo -Staggering gait

the nurse is caring for a client with Huntington's disease who has been admitted to the hospital for treatment of malnutrition. What independent nursing action should be implemented in the client's plan of care?

Apply deep, gentle pressure around the clients mouth to aid swallowing

The nurse is caring for a client who is scheduled for a cervical discectomy the following day. During health education, the client should be made aware of what potential complications?

Hematoma at the surgical site

A client brought to the clinic by the client's spouse and son, is diagnosed with Huntington disease. When providing anticipatory guidance, the nurse should address the future possibility of what effect of Huntington disease

Emotional and personality changes

The nurse is writing a care plan for a client with brain metastases. The nurse decides that the appropriate nursing diagnosis is "anxiety related to lack of control over the health circumstances." In establishing this plan of care for the client, the nurse should include which intervention?

Encouragement to verbalize concerns related to the disease and its treatment

A 25-year-old client with brain metastases is considering life expectancy after the client' most recent meeting with her oncologist. Based on the fact that the client is not receiving treatment for the brain metastases, what is the nurse's most appropriate action?

Ensuring that the clien treceives adequate palliative care

A client has been admitted to the neurologic ICU with a diagnosis of a brain tumor. The client is scheduled to have a tumor resection/removal in the morning. Which of the following assessment parameters should the nurse include in the initial assessment?

Gag reflex

A 37-year-old client is brought to the clinic by the spouse because the client is experiencing loss of motor function and sensation. The health care provider suspects the client has a spinal cord tumor and hospitalizes the client for diagnostic testing. In light of the need to rule out spinal cord compression from a tumor, the nurse will most likely prepare the client for what test?

MRI