PrepU - Adult: Chapter 44
A patient who has been diagnosed with a brain tumor is being cared for in the neurological intensive care unit (ICU) because of a sudden exacerbation of the signs and symptoms of his neoplasm. Which of the following would be indicative of increased intracranial pressure (ICP)?
Severe headache
A patient has been diagnosed with a brain tumor, a glioblastoma multiforme. The nurse met with the family after the diagnosis to help them understand that:
Surgery can improve survival time but the results are not guaranteed.
The spouse of a client with terminal brain cancer asks the nurse about hospice. Which statement by the nurse best describes hospice care?
"Clients and families are the focus of hospice care."
The nurse is providing discharge teaching for a client who was admitted to hospital after having complex partial seizures secondary to a glioma. The client has been prescribed levetiracetam to manage the seizures. What should the nurse include in the discharge teaching for this medication?
"Driving a car should be avoided until the you know how this medication effects you."
A client with post-polio syndrome displays fatigue and decreased muscle strength. How should the nurse best respond to the client?
"Intravenous immunoglobulin infusion may help you."
A client with a malignant glioma is scheduled for surgery. The client demonstrates a need for additional teaching about the surgery when he states which of the following?
"The surgeon will be able to remove all of the tumor."
A client with cerebral metastasis suddenly experiences a seizure for which phenytoin 10 mg/kg intravenously is ordered as an initial loading dose. The client weighs 132 pounds. How many milligrams of phenytoin should the client receive? Enter the number ONLY.
600
A client with cerebral metastasis suddenly experiences a seizure for which phenytoin 10 mg/kg intravenously is ordered as an initial loading dose. The client weighs 165 pounds. How many milligrams of phenytoin should the client receive? Enter the number ONLY.
750
Which medication classification should be avoided in the treatment of brain tumors?
Anticoagulants
While reviewing the nursing documentation on a patient on the neurological unit, the nurse notes that the patient complained of a headache several times over the previous shift. How can the nurse differentiate between a headache that is caused by a brain tumor and a headache that is caused by meningitis or encephalitis?
Assess for the presence of a fever.
Extensive diagnostic testing has resulted in a patient's diagnosis of a benign brain tumor. When providing care for this patient, the nurse should be cognizant of which of the following characteristics of benign brain tumors?
Benign brain tumors can slowly grow into an area of vital brain function.
A client comes to the clinic for evaluation because of complaints of dizziness 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
Which of the following outcomes would be most appropriate to include in the plan of care for a client diagnosed with a muscular dystrophy?
Client participates in activities of daily living using adaptive devices.
The nurse identifies a nursing diagnosis of self-care deficit, bathing related to motor impairment and decreased cognitive function for a client with cerebral metastasis. Which outcome would the nurse most likely identify on this client's plan of care?
Client participates in daily hygiene activities with assistive devices.
A 66-year-old woman with a recent history of headaches and agitation has been found to have a meningioma. The neurological nurse should understand that the symptoms of this woman's tumor are attributable to what pathophysiological process?
Compression of brain tissue
An acoustic neuroma is a benign tumor of which cranial nerve?
Eighth
The nurse is caring for a client with mid-to-late stage of an inoperable brain tumor. What teaching is important for the nurse to do with this client?
Explaining hospice care and services
A 37-year-old mother of three has just been diagnosed with a grade I meningioma. As part of patient education, the nurse tells the patient that:
Growth is slow and symptoms are caused by compression rather than tissue invasion.
A nurse is providing care to a client who has been diagnosed with metastatic brain cancer. When developing the client's plan of care, which outcome would the nurse most likely identify?
Improved quality of life
A nurse assesses a patient who has been diagnosed with having a pituitary adenoma that is pressing on the third ventricle. The nurse looks for the associated sign/symptom. What is that sign/symptom?
Increased intracranial pressure
The nurse is caring for a client with increased intracranial pressure (ICP) after surgical resection of a brain tumor. The nurse recognizes the client is demonstrating late signs of ICP when which sign is observed?
Irregular respirations
A nurse helps a patient recently diagnosed with a pituitary adenoma understand that:
Most tumors produce too much of one or more hormones.
A 30-year-old female patient has been referred to a specialist by her primary care provider because she has recently developed fat pads at the base of her neck, an increasingly round face, and striae at various locations. The patient's signs of illness have been attributed to a brain tumor. What type of brain tumor is most likely to result in these changes to the woman's physical appearance?
Pituitary adenoma
The nurse reviews the patient's drug regimen for treatment of a brain tumor. She explains to the patient why one of the following drugs would not be prescribed, even though it might have therapeutic benefits. Which drug would not be prescribed for this patient?
Coumadin (anticoagulant)
The nurse is assessing a client who was brought to the emergency department due to a severe headache with sudden onset, lowered level of consciousness and slurred, non-sensical speech. The client completed chemotherapy and radiation treatment for a glioma-type brain tumor 6 months ago. The client has been taking low molecular weight heparin since completing treatment. The nurse should be prepared to provide care for which possible problem?
Intracerebral hemorrhage
The nurse is seeing the mother of a client who states, "I'm so relieved because my son's doctor told me his brain tumor is benign." The nurse knows what is true about benign brain tumors?
They can affect vital functioning.
The nurse is seeing a client who has just been diagnosed with a grade I meningioma. The nurse is correct when stating what information about the client's diagnosis?
"Grade 1 is the most common type of this tumor."
A client with Parkinson's disease is prescribed amantadine hydrochloride 100 mg twice a day. The pharmacy supplies amantadine syrup, because the client has a history of difficulty swallowing tablets. The label reads 50 mg/5 mL. How many milliliters would the nurse administer to the client for each dose? Enter the correct number ONLY.
10
A nurse knows that a patient exhibiting seizure-like movements localized to one side of the body most likely has what type of tumor?
A motor cortex tumor
The nurse determines which nursing intervention would best assist the client with a brain tumor who may be at increased risk for aspiration?
Evaluation of gag reflex and ability to swallow
The nurse is caring for a client with mid-to-late stage of an inoperable brain tumor. What teaching is important for the nurse to do with this client?
Explain hospice care and services
A client is diagnosed with a brain angioma. When teaching the client about the risks associated with this type of brain tumor, the nurse would educate about signs and symptoms associated with which condition?
Hemorrhagic stroke
Bone density testing will be completed for the client with post-polio syndrome. The nurse teaches the client bone density testing is used to identify what potential complication?
Low bone mass and osteoporosis
After a transsphenoidal adenohypophysectomy, a client is likely to undergo hormone replacement therapy. A transsphenoidal adenohypophysectomy is performed to treat which type of cancer?
Pituitary carcinoma
The nurse is caring for a client with metastatic brain cancer. The client will be receiving palliative treatment. The nurse should anticipate what type of medical management will be included in the client's care? Select all that apply.
Radiosurgery, Craniotomy with debulking, Radiation
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
A nurse is providing care to a client recently diagnosed with a brain tumor. When planning this client's care, the nurse anticipates which therapy as providing the best outcome for the client?
Surgery
The nurse educator is providing orientation to a new group of staff nurses on an oncology unit. Part of the orientation is to help nurses understand the differences between various types of brain tumors. The nurse educator correctly identifies that glioma tumors are classified based on the fact that they originate where in the brain?
Within the brain tissue
A client is scheduled for diagnostic testing to evaluate the possibility of a brain tumor. The nurse would anticipate preparing the client for which test?
magnetic resonance imaging (MRI)
Corticosteroids are used in the management of brain tumors to
reduce cerebral edema.
The nurse teaches the client diagnosed with Huntington disease that it is transmitted as which type of genetic disorder?
Autosomal dominant
The nurse is conducting a neurological assessment with a client who has increased intracranial pressure secondary to growth of brain tumor mass. What assessment tools can the nurse use to determine the client's neurological status? Select all that apply.
Glasgow coma scale (GCS), Mini mental status examination (MMSE)
The nurse is providing discharge instructions for a client who was admitted to the oncology unit due to dehydration and anorexia after chemotherapy treatment. What information should the nurse provide to the client to promote improve the client's nutritional intake at home?
Take prescribed pain medication prior to commencing a meal
A 37-year-old male is brought to the clinic by his wife because the patient is experiencing loss of motor function and sensation. After initial neurological assessment, the health care provider suspects the patient has a spinal cord tumor and hospitalizes him for diagnostic testing. In preparation for diagnostic studies, the nurse will inform the patient that the most commonly used study to diagnosis spinal cord compression from a tumor is what?
A magnetic resonance imaging (MRI) scan
A 64-year-old woman has been admitted to the neurological unit after being diagnosed with a brain tumor. The woman is slated for neurosurgery the following day, and the woman's daughter has come to the hospital from out of state. After visiting her mother for the first time since she was diagnosed, the daughter is distraught and tells the nurse, "My mother has always been one of the kindest, most considerate people, and I don't remember her ever being so abrasive." How should the nurse best respond to the daughter's statement?
"Those personality changes are probably a result of the tumor's effect on her brain."
Nurses are performing hourly neurological assessments of a patient who is postoperative day 1 following spinal surgery that was performed to treat spinal cord compression (SCC). The nurse's most recent assessment shows a marked reduction in motor and sensory function. How should the nurse best follow-up this assessment finding?
Inform the care provider promptly about this sudden change.
A client with an incurable brain tumor is experiencing nausea and vomiting and has little interest in eating. His family states, "We don't know how to help him." Which of the following would be appropriate for the nurse to suggest to help improve the client's nutritional intake? Select all that apply.
Ensure that the client is free of pain for meals, Plan meals for times when the client is rested, Provide the client with food that he likes.
A client whose physical findings suggest a hyperpituitary condition undergoes an extensive diagnostic workup. Test results reveal a pituitary tumor, which necessitates a transsphenoidal hypophysectomy. The evening before the surgery, the nurse reviews preoperative and postoperative instructions given to the client earlier. Which postoperative instruction should the nurse emphasize?
"You must avoid coughing, sneezing, and blowing your nose."
In which location are most brain angiomas located?
Cerebellum
The nurse is caring for a client who underwent surgery to remove a spinal cord tumor. When conducting the postoperative assessment, the nurse notes the presence of a bulge at the surgical site. The nurse suspects the client is experiencing what complication from the surgery?
Cerebrospinal fluid leakage
A patient diagnosed with a pituitary adenoma has arrived on the oncology unit. Based upon the nurse's initial assessment, the patient is most likely to exhibit:
Headache
The nurse is seeing a female client who has been diagnosed with a pituitary adenoma. During the clinic visit, the client tells the nurse that she has been having irregular menstrual periods despite having very regular menstrual periods all her life. The nurse knows this physiological change is likely related to which characteristic of this type of brain tumor?
Increased prolactin levels
Which diagnostic is most commonly used for spinal cord compression?
Magnetic resonance imaging (MRI)
The nurse is planning the care of a patient who has been admitted to the hospital for surgical treatment of prostate cancer that has metastasized to his spine. When planning nursing care that is specific to this patient's spinal metastasis, what outcome should the nurse identify?
The patient will state that pain control is adequate.
Nursing students are reviewing the various types of brain tumors. The students demonstrate understanding of the material when they identify which of the following as the most common type?
Gliomas