Hinkle Chapter 70: Management of Patients With Oncologic or Degenerative Neurologic Disorders

A client comes to the clinic for evaluation because of complaints of dizzinesss and difficulty walking. Further assessment reveals a staggering gait, marked muscle incoordination, and nystagmus. A brain tumor is suspected. Based on the client's assessment findings, the nurse would suspect that the tumor is located in which area of the brain?

Cerebellum

The nurse is caring for a client who has been hospitalized for investigation of a sudden change in gait due to loss of balance and coordination. A magnetic resonance imaging scan reveals the client has a brain tumor. On or close to which brain structure is the tumor most likely situated?

Cerebellum

What diagnostic study provides visualization of cerebral blood vessels?

Cerebral angiography

The nurse is caring for a client hospitalized after a motor vehicle accident. The client has a comorbidity of Parkinson's disease. Why should the nurse closely monitor the condition and the drug regimen of a client with Parkinson's disease?

Drugs administered may cause a wide variety of adverse effects

The nurse determines that the patient's voice has changed since the last visit and is now more difficult to understand. How should the nurse document this finding?

Dysphonia

The nurse identifies a nursing diagnosis of imbalanced nutrition, less than body requirements related to difficulty in chewing and swallowing for a client with Parkinson's disease. Which of the following would be most appropriate for the nurse to integrate into the client's plan of care?

Encourage the client to massage the facial and neck muscles before eating.

A nurse is reviewing a client's medical record and finds that the client has a spinal cord tumor that involves the vertebral bodies. The nurse identifies this as which type of spinal tumor?

Extradural

A client is admitted reporting low back pain. How will the nurse best determine if the pain is related to a herniated lumbar disc?

Have the client lie on the back and lift the leg, keeping it straight.

The nurse is providing discharge teaching to a client with a spinal cord tumor and instructs the client to avoid hot water bottles and heating blankets for what reason?

Impaired sensory perception

The nurse is caring for a patient with Parkinson's disease and is preparing to administer medication. What does the nurse administer to the patient that is considered the most effective drug currently given for the tremor of Parkinson's?

Levodopa

A client has a herniated disk in the region of the third and fourth lumbar vertebrae. What nursing assessment finding most supports this diagnosis?

Lower back pain

The nurse explains to the client with projectile vomiting and severe headache that a medication is being prescribed to reduced edema surrounding the brain and lessen these symptoms. What medication is the nurse preparing to administer?

Mannitol

This test is most diagnostic for brain activity, as well as for assessment of tumor size. It can also be useful in differentiating a tumor from scar tissue or radiation necrosis.

PET scan

This is a late symptom of spinal cord compression

Paralysis

A patient whose lab work indicates excessively high levels of thyroid stimulating hormone would most likely be diagnosed with which type of tumor?

Pituitary adenoma

A client with an incurable brain tumor is experiencing nausea and vomiting and has little interest in eating. What would be appropriate for the nurse to suggest to help improve the client's nutritional intake?

Plan meals for times when the client is rested. Provide the client with foods that he likes. Ensure that the client is free of pain for meals.

Corticosteroids are used in the management of brain tumors to

Reduce cerebral edema

A client with a cerebellar brain tumor is admitted to an acute care facility. The nurse formulates a nursing diagnosis of Risk for injury. What "related-to" phrase should the nurse add to complete the nursing diagnosis statement?

Related to impaired balance

A client has undergone surgery for a spinal cord tumor that was located in the cervical area. The nurse would be especially alert for which of the following?

Respiratory dysfunction

An acoustic neuroma is a benign tumor of which cranial nerve?

VIII

The nurse is seeing a client who is suspected of having a glioblastoma multiforme tumor. The nurse anticipates the client will require which diagnostic test to confirm the client has this form of brain tumor?

Tissue Biopsy

What is the only known risk factor for brain tumors?

Ionizing radiation

These tumors are usually slow growing but can occur in a vital area, where they can grow large enough to cause serious effects.

Benign

The nurse is providing postoperative care for a client who just underwent surgery to remove a metastatic intramedullary tumor. On postoperative day 3, the client states, "I am really looking forward to going running again, it had become too difficult because of the loss of feeling in my feet." What should the nurse address in the client's care plan?

Knowledge deficit Clients with extensive neurologic deficits before surgery usually do not make significant functional recovery, even after successful tumor removal.

To avoid twisting the spine or hips when turning a client onto the side who is postop laminectomy to repair a herniated intervertebral disk, the nurse should use the

logroll technique