Brain Tumors

  1. General information
    1. Tumor within the cranial cavity; may be benign or malignant
    2. Types
      1. Primary: originates in brain tissue (e.g., glioma, meningioma)
      2. Secondary: metastasizes from tumor elsewhere in the body (e.g., lung, breast)
  2. Medical management
    1. Craniotomy: to remove the tumor when possible
    2. Radiation therapy and chemotherapy: may follow surgery; also for inaccessible tumors and metastatic tumors
    3. Drug therapy: hyperosmotic agents, corticosteroids, diuretics to manage increased ICP
  3. Assessment findings
    1. Headache: worse in the morning and with straining and stooping
    2. Vomiting
    3. Papilledema
    4. Seizures (focal or generalized)
    5. Changes in mental status
    6. Focal neurologic deficits (e.g., aphasia, hemiparesis, sensory problems)
    7. Diagnostic tests
      1. Skull x-ray, CT scan, MRI, brain scan: reveal presence of tumor
      2. Abnormal EEG
      3. Brain biopsy
  4. Nursing interventions
    1. Monitor vital signs and neuro checks; observe for signs and symptoms of increased ICP.
    2. Administer medications as ordered.
      1. Drugs to decrease ICP, e.g., dextromethasone (Decadron)
      2. Anticonvulsants, e.g., phenytoin (Dilantin)
      3. Analgesics for headache, e.g., acetaminophen (Tylenol)
    3. Provide supportive care for any neurologic deficit (see Cerebrovascular Accident).
    4. Prepare client for surgery (see Craniotomy).
    5. Provide care for effects of radiation therapy or chemotherapy (see Oncologic Nursing).
    6. Provide psychologic support to client/significant others.
    7. Provide client teaching and discharge planning concerning
      1. Use and side effects of prescribed medications.
      2. Rehabilitation program for residual deficits.