NURS 405A - Exam 2 > Brain Tumors > Flashcards

Brain Tumors Flashcards

(49 cards)

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1
Q

How do brain tumors lead to death? (2)

A
  • Impaired vital function
  • ICP
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2
Q

What are the 2 subsets of primary tumors?

A
  • Intracerebral tumors
  • Tumors arising from supporting structures
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3
Q

What are the types of gliomas? (2)

A
  • Astrocytomas
  • Glioblastomas (most malignant)
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4
Q

What are the types of intracerebral tumors? (3)

A
  • Oligodendrogliomas
  • Ependymomas
  • Medulloblastomas
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5
Q

Describe oligodendrogliomas (3)

A
  • Benign
  • Slow growing
  • Sensitive to chemotherapy
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6
Q

Describe ependymomas (2)

A
  • Can be benign or malignant
  • Difficult to treat due to location (ventricles)
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7
Q

Describe medulloblastomas (2)

A
  • Aggressive
  • Highly malignant to spinal cord and remote areas of the brain
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8
Q

What are the types of tumors arising from supporting structures? (3)

A
  • Meningiomas
  • Pituitary adenomas
  • Neuromas (acoustic neuroma / schwannoma)
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9
Q

Describe meningiomas (2)

A
  • Benign
  • Slow growing
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10
Q

Describe pituitary adenomas (2)

A
  • WIDE variety of symptoms (confusion during diagnosis)
  • Rarely malignant
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11
Q

Pressure on what areas cause manifestations of pituitary adenomas? (3)

A
  • Optic nerve
  • Hypothalamus
  • Third ventricle
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12
Q

What are the general manifestations of pituitary adenomas? (3)

A
  • Diabetes
  • Sleep disturbances
  • Changes in appetite
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13
Q

What are the manifestations of prolactin-secreting pituitary adenomas in females? (2)

A
  • Amenorrhea
  • Galactorrhea
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14
Q

What are the manifestations of prolactin-secreting pituitary adenomas in males? (2)

A
  • Impotence
  • Hypogonadism
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15
Q

What is the primary effect of growth hormone-secreting pituitary adenomas?

A

Acromegaly (abnormal growth of hands, feet, face etc.)

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16
Q

What is the primary effect of ACTH-secreting pituitary adenomas?

A

Cushing’s disease

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17
Q

What are the manifestations of Cushing’s disease? (7)

A
  • Moon face
  • Central obesity
  • Weakness
  • Frail bones
  • Hirsutism
  • Hypertension
  • Erectile dysfunction
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18
Q

Describe neuromas (acoustic neuromas / schwannomas) (3)

A
  • Benign
  • Slow growing
  • Large at time of diagnosis
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19
Q

Where are neuromas (acoustic neuromas / schwannomas) located?

A

Schwann cells in cranial nerve VIII

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20
Q

Neuromas (acoustic neuromas / schwannomas) primarily affect what functions?

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A

Hearing / balance (tinnitus / vertigo)

21
Q

How do secondary brain tumors metastasize?

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A

Hematological / lymphatic spread

22
Q

Treatment of secondary brain tumors is usually ______

23
Q

What are the general manifestations of brain tumors? (8)

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A
  • Headache - most common
  • Wernicke’s / Broca’s aphasia
  • Visual disturbances
  • Motor changes
  • Sensory changes
  • Nausea / vomiting
  • Seizures
  • ICP
24
Q

When are headaches from brain tumors most severe? (2)

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A
  • When the patient first awakens
  • When coughing / straining
25
A headache radiating between the temples is an indication of what type of tumor?
Pituitary adenoma
26
A headache in the sub-occipital region is an indication of what type of tumors? (3)
- Medulloblastomas - Meningiomas - Schwannomas
27
A tumor is what area often produces seizures as the first symptom?
Temporal lobe
28
What visual disturbances are associated with brain tumors? (4)
- Diplopia - Papilledema - Hemianopsia - Cranial nerve VI palsy
29
What motor changes are associated with brain tumors? (3)
- Hemiparesis - Hemiplegia - Ataxia
30
What sensory changes are associated with brain tumors? (3)
- Hyperesthesia - Astereognosis - Agnosia
31
What is the earliest sign of intracranial pressure?
Change in LOC / slowed speech
32
What test is most helpful for the diagnosis of a brain tumor?
MRI (with contract)
33
What test is contraindicated for diagnosis of a brain tumor with increased ICP?
Lumbar puncture - herniation of pressure down spinal cord will cause rapid loss of CSF
34
What is the preferred treatment for most brain tumors?
Surgery
35
Describe transsphenoidal microsurgery (3)
- Used for pituitary adenomas - Minimally invasive - does not require opening the skull - Enters through the nose and into the pituitary gland to resect tumor cells
36
Describe post-op nursing interventions associated with brain surgery (3)
- Hourly neuro checks - DO NOT position on operative side - DO NOT cough / blow nose
37
______ is used to decrease the incidence of brain tumor reoccurrence if incompletely resected
Radiation
38
Describe stereotactic radiosurgery for brain tumors (3)
- Gamma knife - Very precise - Preserves surrounding healthy tissue
39
Describe nursing considerations associated with external beam radiation (2)
- DO NOT use alcohol / powder / cream - can cause severe burns - DO NOT wash off markings
40
What is the primary complication associated with internal beam radiation?
Cerebral edema / ICP
41
Why is chemotherapy for brain tumors not always effective?
Difficult to pass blood-brain barrier - may be easier in malignant tumors due to breakdown of blood-brain barrier
42
How is intrathecal chemotherapy administered?
Ommaya reservoir / lumbar puncture
43
What chemotherapy agent is used to treat malignant gliomas?
Temozolomide (Tremodar) - monitor for myelosuppression
44
Describe the function of Temozolomide (Tremodar)
Crosses blood-brain barrier to directly interfere with tumor growth
45
What is the primary education associated with Temozolomide (Tremodar)?
Take on empty stomach (PO)
46
Describe mixing of chemotherapy agents for brain tumors
Preservative free solution and steroid
47
What targeted therapy agent is used for brain tumors?
Bevacizumab (Avastin) - antiangiogenesis agent
48
Describe the primary nursing consideration associated with Bevacizumab (Avastin)
Can cause wound healing issues
49
What medications should be avoided for a patient with a brain tumor?
Fentanyl / morphine - risk of CNS depression
NURS 405A - Exam 2
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