Managing The Client With Problems On Cellular Aberration: Brain Cancer

Republic of the Philippines
UNIVERSITY OF NORTHERN PHILIPPINES

Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
Website: www.unp.edu.ph Mail: unp_nursingvc@yahoo.com
CP# 09177148749, 09175785986
MANAGING THE CLIENT WITH PROBLEMS ON

CELLULAR ABERRATION: BRAIN CANCER
MODULE DESCRIPTION:
This module contains the pathophysiology and the management of brain cancer as well as
the different aspects of nursing care that the student nurse should know regarding the client.
PRE-TEST
1. This hypothesis describes the delicate balance of the 3 major components in the
intracranial vault, and if one increases, the other must compensate by reducing or moving
to attain or maintain the intracranial pressure
a. Monro-Kellie Hypothesis
b. Bernouillie’s principle
c. Kernohan’s phenomenon
d. Charcot’s triad
2. A type of brain cancer cell that arise from astrocytes and is considered t be the most
aggressive type of brain cancer
a. Astrocytoma
b. Glioblastoma multiforme
c. Teratoma
d. Schwannoma
3. Focal symptoms of brain tumors are independent of their location in the brain.
a. True
b. False
c. No idea
d. May or may not be
4. All of the following are signs of meningismus except:
a. Nuchal rigidity
b. Photophobia
c. Nystagmus
d. Projectile vomiting
5. All except are chemotherapeutic drugs that can be administered through intrathecal route:
a. Vincristine
b. Methotrexate
NCM 112: BRAIN CANCER BY: LEWIS PAUL SABLAY, RN

Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
c. Dexamethasone
d. Ara-C
MODULE CONTENT:
 Tumors in the central nervous system arises from two main factors: PRIMARY
TUMORS and CEREBRAL METASTASES.
 Due to the anatomy and physiology of the CNS, neoplastic processes are challenging to
diagnose and treat.
 The goal of treatments of any growth in the CNS, particularly in the brain are:
o Early recognition of signs and symptoms
o Prevent or treat irreversible brain injury and death
 Any space-occupying lesion in the brain, i.e, tumor of primary or metastatic in origin can
cause:
o Acute or chronic increase intracranial pressure or intracranial hypertension
o Acute brain herniation
o Permanent neurologic deficits and disability
o Acute or chronic, severe pain.
o Poor neurologic outcomes
 Treatment of brain tumors or cancers are especially delicate and sometimes difficult tasks
as it cancer modalities may have lasting impact on the quality of life of the client.
RISK FACTORS:
1. Exposure to ionizing radiation
2. Invasive viral diseases (e.g. HIV)
3. Exposure to low-frequency radiation*
4. Hair dyes*
5. Head trauma*
6. Nitrates*
*- these risks factors have no concrete or solid evidence and existing studies are conflicting.

Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
PATHOPHYSIOLOGY
BRAIN CANCER
PRIMARY METASTATIC
TUMOR GROWTH
GROWTH OF DISRUPTION OF FLUID-PRODUCING INFLAMMATORY

TUMOR IN THE THE NORMAL CANCER PROCESS/PERI-
RIGID CRANIAL FLOW OF CSF GROWTH/INTRA- TUMORAL EDEMA
VAULT TUMORAL
HEMORRHAGE
INCREASED ICP
(INTRACRANIAL
HTN)
SIGNS AND
SYMPTOMS/COMPLICATIONS
COMMON COMPLICATIONS OF NEOPLASTIC MASS IN THE CRANIUM:

1. Increased intracranial pressure (IICP) or intracranial HTN
a. The intracranial vault is an unyielding cavity of the skull, thus the volume of the
intracranial components as described by the Monro-Kellie hypothesis, must be
maintained. These components are the:
i. CSF
ii. Blood
iii. Brain tissue
2. Brain herniation
a. When intracranial HTN is not addressed or relieved, the brain tissue has the
potential to herniate to several herniation points.
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
3. Cerebral edema
4. Seizure and focal neurologic signs
5. Hydrocephalus
a. HCP is caused by the direct obstruction of the tumor growth, excessive fluid
production of the cancer cells or intracranial HTN of the draining pathways of the
CSF.
6. Altered pituitary functions
7. Coma
8. Temporary or permanent neurologic deficits
SIGNS AND SYMPTOMS

 The signs and symptoms of intracranial neoplastic processes are dependent on the
location of the tumor growth or may also be generalized neurologic manifestations due to
intracranial HTN.
 Generalized symptoms:
o Meningismus
 Kernig’s sign
 Brudzinki’s sign
 Nuchal rigidity
 Photophobia
 Headache
 Nausea and vomiting
 Projectile vomiting
 Headache
 Cushing’s triad- signs of herniation
 Most common in the early morning and aggravated by coughing,
straining or sudden movement
 The focus of pain is related to the location of the tumor
 The headache is sometimes described as dull and unrelenting.
 Papilledema
 Edema of the optic disk
o Visual disturbances
 Diplopia
 Decreased visual acuity and visual field deficits (e.g hemiaopsia)
 Localized symptoms
o Symptoms are related to the focus of the tumor growth or tracts that are affected
by the neoplastic growth
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
o Seizure-like movements like Jacksonian seizures: motor cortex tumor

o Contralateral homonymous hemiaopsia: occipital lobe tumor
o Dizziness, ataxic staggering gait, muscular incoordination, nystagmus: cerebellar
tumor
o Personality disorders, mental and emotional changes: frontal lobe tumors
o Tinnitus, vertigo, progressive nerve deafness, paralysis: cerebellopontine angle
tumor.
PRIMARY BRAIN TUMORS TYPES:

INTRA TYPES SUB-TYPES DESCRIPTION
CEREBRAL
TUMORS
Intracerebral Gliomas  Astrocytomas  May arise from
tumors  Infiltrate  (grade I and II) the brain or spinal
any cord
portion of  Originated from
the brain; astrocytes, cells
most that support nerve
common cells
type of  Glioblastoma  Most aggressive
brain multiforme type of brain
tumor (astrocytoma cancer
grade III and
IV)
 Oligodendrocy  Otherwise known
toma (low and as
high grades) oligodendrogliom
a
 Originates from
oligodendrocytes,
cells responsible
in the production
of the myelin
sheath.
 Ependymoma  Tumors arising in
the ependymal
cells of the brain
and spinal cord.
 Ependymal cells

Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
are neuroglial
cells that provide
support to the
ventricular
cavities of the
brain.
 Medullablasto  Most common
ma type of pediatric
brain cancer.
 Arise from the
structures of the
lower back of the
brain, the
cerebellum.
Tumors arising Meningiomas N/A  Encapsulated
from the tumors of the
supporting arachnoid cells on
structures of the the meninges.
CNS Neuromas  Acoustic  Tumor of CN
neuroma VIII
 Schwannoma  Are usually
benign tumors
that arise from the
Schwann cells of
the peripheral NS.
 Pituitary  Tumor cells that
adenomas arise within the
structures of the
pituitary gland,
which can have a
direct impact on
the hormonal
functions of the
hypophysis.
Developmental  Angiomas  Benign tumors of
Tumors the capillaries in
the brain or spinal
cord.
 Dermoid  Are benign, slow-
tumors growing

Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
encapsulated
tumors that grow
anywhere in the
CNS.
 The term dermoid
means that the
new growth has
skin-like elements
like hairs, sweat
glands, etc.
 Epidermoi  Are embryonic
d benign tumors in
the brain, that are
trapped in the
cerebral
parnechyma
during the
embryonic stage,
which give rise to
skin-like
elements.
 Teratoma  Are
developmental
and embryonic
stem cells that are
trapped in the
brain that should
gave rise to
epithelial
structurs like
skin, bones, skull,
etc.
 Usually benign
tumors.
 Craniopha  Are usually
ryngioma benign tumors
that grow near or
within the
pituitary gland
and are usually
hormone
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
secreting.
 May have
malignant
tendency.
Metastatic  Are extracerebral
lesions tumors that
originates outside
the cranium or
structures of the
CNS that has
invaded and
established
growth in the
CNS and adjacent
structures.
 Usually from
invasive and
advanced stages
of cancers like
cervical, lung,
oropharyngeal,
leukemia,
melanoma, etc.
ASSESSMENT:
History:
 H/a, seizures usually with post-ictal Todd’s paresis, neurologic dysfunctions with no
vascular or non-traumatic origins or explanation
 Focal deficits based on structural disease
Diagnostics:
 CT scan of the head with or without contrast
 Functional MRI or SPECT imaging
 CSF analysis and cytologic examinations via lumbar puncture
 External ventricular device/drain (EVD): for monitoring of ICP in cases of
intracerebral HTN and/or evacuate CSF, if needed.
 EEG- to detect waveform that are indicative of the non-convulsive seizures.

Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
MANAGEMENT:
PHARMACOLOGIC THERAPY
 Chemotherapy
o The goal of chemotherapy in brain cancer:
 Eliminate cancer cells (primary or metastatic)
 Reduce tumor size to resolve complication/s of brain new growth
o One of the challenges in brain cancer treatment is that many chemotherapeutic
drug may not be able to penetrate effectively the blood-brain barrier.
 Common chemo-drugs used for brain neoplasms are:
 Temozolomide
 Procarbazine
 Carmustine
 Lomustine
 Vincristine
 Cisplatin
 Etoposide
o Intrathecal delivery of chemotherapy
drugs
 The injection of chemodrugs
into the fluid that lines the
brain and the spinal cord.
 Non-vesicant chemo-drugs are
exclusively used for this type
of delivery.
 Common chemodrugs used
are:
 Methotrexate
 Cytosine arabinoside
(Ara-C)
 Corticosteroids
 Alternative to an LP for intrathecal administration is the use of :Ommaya
reservoir”, an appliance is applied through the scalp going to the
intraventricular cavity, where chemo-drugs can be administered,
repeatedly without frequent LP.

Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
 Osmotic diuretics
o Used to reduce the ICP which is the common complication of the a brain-
occupying lesion
 Mannitol or hypertonic saline solution (HTS) usually more than 7.5% NSS
administered centrally.
o Corticosteroids
 Reduces peritumoral vasogenic edema
 Usually dexamathesone IV
 Should be avoided prior to biopsy, if the cerebral lesion may come from
lymphoma or if infectious process is suspected or cannot be ruled-out.
o Antibiotics
 If the brain tumor is suspected to be infected.
 Empiric antibiotic therapy that has the ability to cross the BBB.
o Hemostatics and anti-hypertensives
 Hemostatics (tranexamic acid IV, aminocaproic acid, phytomenadione or
prothrombin complex concentrate/PCC), if with signs or confirmed intra-
tumoral hemorrhage
 Anti-hypertensives are administered to decrease the pressure inside the
brain vasculature, thus reducing bleeding.
 Esmolol IV
 Nicardipine IV
 Clevidipine IV
 Anti-seizure medications
o Used to manage seizures that may be caused directly by the compression of the
brain or as an effect of IC HTN
 Midazolam- can be administered IM when no IV access is available
 Lorazepam- when IV access is available
 Diazepam- can be given per rectum
 Pain medications
o Because the intracranial vault is rigid, brain cancers can cause excruciating
headaches to the client especially in late stages. Thus, good pain management is
needed.
o Opioids/narcotics are the gold standard for cancer pain management.
o Morphine may aggravate ICP due to its ability to affect carbon dioxide
elimination. Alternative maybe fentanyl or hydromorphone.

Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
RADIOTHERAPY
 The use of high-energy beam or particles to kill any actively dividing cancer cells.
 Also used to shrink tumors to manage complications of brain cancer.
 Usually delivered externally.
 Many modern radiotherapy device uses a computer software that combines neuroimaging
obtained from CT, MRI or PET scans to electronically direct beams to precise location of
the tumor, accounting for the slightest movement from the patient (as it is nearly
impossible to let the patient stay still), the flow of blood in the surrounding structures and
the amount of radiation delivered to penetrate effectively the tumor, sparing the
surrounding normal tissues.
 Example of this is the gamma-ray knife.
INVASIVE and DECOMPRESSIVE TREATMENT MODALITY

 Invasive surgical procedure (e.g. craniotomy) may be done if:
o The tumor has not yet spread grossly in the brain structures.
o Tumor location does not affect major physiologic and cognitive function.
o Tumor size is still manageable.
o Tumor is not located deep within the brain parenchyma
 External ventricular device
o The insertion of a ventricular screw to insert a shunt that relieves IC HTN or HCP
by draining excessive or stagnant CSF.
o A multi-lumen device may be used to measure ICP using a manometer or
electronically.
An external ventricular drainage

connected to a manual manometer

Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
(https://www.google.com/search?
q=external+ventricular+drain&sxsrf=ALeKk01xakc9EIksWUr51luM1n45ZfJzmQ:1607158755342&source=lnms&tbm=isch&s
a=X&ved=2ahUKEwjtr9b1vLbtAhXXfd4KHSI3Ax4Q_AUoAXoECAwQAw&biw=1366&bih=657#imgrc=Cy-sspXZGEMrBM)
An electronic ICP monitor connected to an

intraventricular screw
(https://www.google.com/imgres?imgurl=https%3A%2F%2Fqtxasset.com
%2Fsensorsmag%2F1546458031%2FMARKET_1_H.jpg
%3F.87hnF_b2xq4LaZ7_QczG7ZB5Ls58ADT&imgrefurl=https%3A%2F
%2Fwww.fierceelectronics.com%2Fcomponents%2Fintracranial-pressure-
monitoring-a-growing-market&tbnid=-
6UqEX3SzRdgcM&vet=12ahUKEwiDosLxvbbtAhVV0mEKHbMGAkcQMygVegUIARDzAQ..i&docid=LWF8YiiYvtjGQM&w=966&h=725&q=i
cp%20monitor&ved=2ahUKEwiDosLxvbbtAhVV0mEKHbMGAkcQMygVegUIARDzAQ)
An external ventricular drain with electronic

ICP monitor (schematic representation)
https://www.google.com/search?
q=icp+monitor&tbm=isch&ved=2ahUKEwjYreu0vbbtAhVaEnAKHcLHCrIQ2-
cCegQIABAA&oq=icp+monitor&gs_lcp=CgNpbWcQAzIECAAQQzICCAAyAggAMgIIADICCAAyAggAMgIIADIC
CAAyAggAMgIIADoFCAAQsQM6BwgAELEDEENQsqgHWNm-
B2CFxgdoAXAAeACAAa0BiAGZC5IBAzMuOZgBAKABAaoBC2d3cy13aXotaW1nwAEB&sclient=img&ei=Z0zLX5
jeMNqkwAPCj6uQCw&bih=657&biw=1366#imgrc=lW6GupW7X1DYPM

Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
MANAGING THE CLIENT WITH BRAIN CANCER
1. Monitor the client’s neurologic function as indicated. WOF worsening or any new onset
neurologic symptoms. Be wary of any signs of impending IICP or brain hernation.
2. Monitor vital signs. Remember that concurrent manifestations of signs related to
Cushing’s triad is an uncommon phenomenon and may present often later.
3. Monitor serum and urine osmolality, I’s and O’s and daily weight, assessing signs of
fluid retention or depletion due to pituitary issues that may arise from brain tumors.
4. Coordinate the care of the client by involving the neurocritical and neuroscience
specialists.
5. Administer pain killers as indicated as needed. WOF signs of hypercarbia especially in
patients given with morphine SO4.
6. Always maintain a “crash cart” at the bedside.
7. Administer pharmacologic therapies as ordered and as appropriate.
8. Assist in lumbar puncture, if needed, when collecting CSF for cytologic examination.
a. Can be done even if there is suspicion of IICP (or actual presence of), however,
the clinician MUST check first the opening pressure (OP) prior to the removal of
the stylet. An ICP of more than 400mm H2O, the stylet of the spinal needle
should remain in place and an infusion of mannitol can be administered. Recheck
the ICP prior to removal of the stylet. Persistently elevated ICP, emergency
placement of EVD may be warranted.
b. Let the patient assume a supine position, keeping the head to a neutral or the HOB
less than 15° following the procedure.
9. Provide and maintain a quiet environment.
10. Provide adequate nutrition.
11. Provide emotional support.
12. Maintain asepsis and monitor any signs of infection in the insertion site of EVD or post-
operative site.
13. Provide meticulous skin care to client undergoing external radiotherapy.
14. Monitor ICP waveforms

Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
(Image from the ENLS: Intracranial Hypertension and Brain Herniation module)
a. Waveform presentation
i. P1: percussion wave; thought to reflect arterial pulsation
ii. P2: tidal wave; thought to reflect degree of intracranial compliance
iii. P3: dicrotic wave; thought to reflect aortic valve closure
b. When the height of P2 becomes closer to P1, represents an IICP, but the patient is
still able to compensate.
c. When P2 > P1; indicates poor compliance and the patient is at risk for impending
brain hernation. Be on ALERT, the patient will deteriorate soon, if not addressed
QUICKLY and APPROPRIATELY.
15. Referral to long-term care facility, if client has permanent neurologic deficits due to
incurable brain cancer or as a sequalae of brain surgery or complications.
16. Educate on end-of-life measures such as DNR, other advance healthcare directives or
organ donation.
17. Help client with self-care needs in accordance with the level of deficits
18. Prevent straining by giving high-fiber diet, increase oral fluid or stool softeners.
Minimize coughing or sneezing by administering peripherally-acting antitussives and
antihistamines as prescribed.
NURSING PEARL: Managing the client on intrathecal administration of chemo-drugs

1. Ensure that institutional policy on intrathecal administration of chemotherapeutic drugs
are strictly observed.
2. Ensure that the client was able to understand the procedure, its risks and benefits and
possible alternatives.
3. Ensure that informed consent has been obtained prior to the procedure and all questions
and concerns of the client has been raised and properly address.
4. Ensure that the physician’s order, especially the drug name and dosage are written
correctly, legible and is of the correct dose.
5. Ensure that proper and needed equipment is/are ready prior to the entry of the client to
the OR.
6. Provide the client and his/her immediate family or caregiver education about the
treatment modality.
7. Ensure that pre-operative and intraoperative procedures are observed. Strict compliance
to asepsis is paramount. Proper handling, storing and disposing of chemotherapeutic
drugs should be observed and implemented at all times.

Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
8. Monitor and document patient’s response. WOF the following:

a. Fever
b. Persistent dizziness or headache
c. Pain in the spine
d. Pain, numbness or tingling sensation in the lower or upper extremities
e. Difficulty walking
f. Bowel and bladder incontinence that aren’t present prior to procedure
9. Ensure the patency and of the Ommaya reservoir. Monitor and educate the client about
signs and symptoms of infection.
POST-MODULE TEST
1. A client arrived in the clinic complaining of the recurrent dull headache aggravated by
sudden movement, deterioration of gait and diplopia. Which of the following should the
nurse suspect?
a. CNS infection
b. Drug intoxication
c. Brain tumor
d. Intracranial HTN
2. You are caring for a client diagnosed with lung cancer stage IV, with possible metastasis
in the brain. Which of the following should the nurse include in the plan of care? Select
all that apply.
a. Monitor the I and O
b. Evaluate GCS every 4 hours
c. Monitor ABG results as prescribed
d. Provide the client with stimulating and well-lighted room
e. Provide low-residue diet
3. The client is about to undergo intrathecal administration of a steroid, dexamethasone this
afternoon. You are checking the client’s chart when you realize that the oncologist has
written “Ara-C” instead of dexamethasone. You called the oncologist, yet he is out-of-
network coverage. Which of the following should you do?
a. Use a “white-out” ink and correct the order of the oncologist.
b. Call your immediate supervisor and report the findings.
c. Call the Quality Assurance Committee and report the incorrect order of the
physician.
d. Go ahead with the procedure, maybe the oncologist changed his mind.
4. A client with glioblastoma multiforme grade IV was about to be discharged. He has gross
visual deficits and is paralyzed from the waist down. He is most of the times, drowsy and
is on NGT feeding. His immediate family members expressed their concerns that they

Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
might not be able to provide the complex care he needs. Which of the following nursing
diagnosis is appropriate?
a. Impaired sensory perception
b. Risk for aspiration
c. Interrupted family processes
d. Caregiver role strain
5. A client was admitted due to astrocytoma grade II, stage 3B. He has EVD in place and
was on ICP monitoring. He was prescribed with 12% hypertonic saline 70ml every 4
hours as IV bolus to control ICP. As you are about to prepare the 10am dose of the 12%
HTS, the morning laboratory result came in showed the client’s serum Na+ is 167mEq/L.
which of the following should the nurse do?
a. Give half of the 10am dose and ask for a repeat serum Na+ prior to the 2pm dose.
b. Give the whole dose but infuse it for 2 hours.
c. Withhold the 10am dose and refer to the physician
d. Ask for a repeat serum Na+ STAT, but give the 10am dose.
6. A client post-intrathecal administration of methotrexate is about to be admitted in your
floor. While assessing the client, which of the following statement, if made by the client
should prompt the nurse an immediate action?
a. “I feel a little pricky pain in the puncture site.”
b. “I feel pins and needles in my toes.”
c. “I feel a little nauseous.”
d. “Can I have some time alone?”
7. You are monitoring a client with metastatic brain lesion deep into the midbrain region.
He is about to undergo stereotactic external beam radiotherapy. Which of the following,
if made by the client, will prompt the nurse further clarification?
a. “I have to lie still as possible as the radiation session is ongoing and throughout
the session.”
b. “They will inject a dye into my veins and shoot X-rays to my head. The dye will
amplify the effect of the X-ray to the tumor cells and kill them.”
c. “A powerful beam will be focused to where my tumor is sparing most of the other
normal tissues.”
d. “I may experience a sun-burnt like effect after the procedure.”
8. You are watching the ICP monitor, noting the ICP waveforms. Which of the following
correctly state what P3 is?
a. Corresponds to the repolarization of the ventricles.
b. Reflect the dicrotic wave corresponding to the aortic valve closure
c. Denotes the degree of intracranial compliance
d. Denotes the arterial pulsations

Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
9. The client with metastatic cerebral lesion originating from invasive gastrinoma was about
to be given with tranexamic acid 1 gram IV every 8 hours. The nurse understands that
hemostatics are given to patients with intracerebral lesions because which of the
following:
a. Finding of cerebrovascular accident concurrent with the tumor
b. Coagulopathy due to paraneoplastic syndromes
c. Bleeding of the stomach due to gastrinoma
d. Intra-tumoral hemorrhage
10. A client has undergone transphenoidal hypophysectomy 3 days ago to remove a primary
tumor in the pituitary gland. Which of the following assessment parameters should the
nurse worry about?
a. A blood pressure of 107/75mmHg
b. A WBC count of 7.5
c. A serum sodium of 146 mEq/L
d. A urine specific gravity of 1.027
CRITICAL THINKING
Make a care plan to address the following nursing diagnoses related to brain cancer
 Altered sensory perception
 Self-care deficit
 Altered family processes
 Anticipatory grieving
In making the care plan use the following format:

Nursing Possible Signs and Scientific Interventions Rationale
diagnosis etiology symptoms explanation
(with
algorithm)
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Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
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https://www.google.com/search?q=ommaya+reservoir&sxsrf=ALeKk00ReHBJ7J-2s1Qy3gJcf-
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Managing The Client With Problems On Cellular Aberration: Brain Cancer

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Managing The Client With Problems On Cellular Aberration: Brain Cancer

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Republic of the Philippines

UNIVERSITY OF NORTHERN PHILIPPINES

MANAGING THE CLIENT WITH PROBLEMS ON

NCM 112: BRAIN CANCER BY: LEWIS PAUL SABLAY, RN

NCM 112: BRAIN CANCER BY: LEWIS PAUL SABLAY, RN

GROWTH OF DISRUPTION OF FLUID-PRODUCING INFLAMMATORY

COMMON COMPLICATIONS OF NEOPLASTIC MASS IN THE CRANIUM:

SIGNS AND SYMPTOMS

o Seizure-like movements like Jacksonian seizures: motor cortex tumor

PRIMARY BRAIN TUMORS TYPES:

NCM 112: BRAIN CANCER BY: LEWIS PAUL SABLAY, RN

NCM 112: BRAIN CANCER BY: LEWIS PAUL SABLAY, RN

NCM 112: BRAIN CANCER BY: LEWIS PAUL SABLAY, RN

NCM 112: BRAIN CANCER BY: LEWIS PAUL SABLAY, RN

NCM 112: BRAIN CANCER BY: LEWIS PAUL SABLAY, RN

INVASIVE and DECOMPRESSIVE TREATMENT MODALITY

An external ventricular drainage

NCM 112: BRAIN CANCER BY: LEWIS PAUL SABLAY, RN

An electronic ICP monitor connected to an

An external ventricular drain with electronic

NCM 112: BRAIN CANCER BY: LEWIS PAUL SABLAY, RN

MANAGING THE CLIENT WITH BRAIN CANCER

NCM 112: BRAIN CANCER BY: LEWIS PAUL SABLAY, RN

NURSING PEARL: Managing the client on intrathecal administration of chemo-drugs

NCM 112: BRAIN CANCER BY: LEWIS PAUL SABLAY, RN

8. Monitor and document patient’s response. WOF the following:

NCM 112: BRAIN CANCER BY: LEWIS PAUL SABLAY, RN

NCM 112: BRAIN CANCER BY: LEWIS PAUL SABLAY, RN

In making the care plan use the following format:

NCM 112: BRAIN CANCER BY: LEWIS PAUL SABLAY, RN

NCM 112: BRAIN CANCER BY: LEWIS PAUL SABLAY, RN

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