Nursing 211

N211: Health Differences Across the Lifespan I Angiomas are composed mainly of abnormal blood vessels. The blood vessel walls are thin, making the client susceptible to hemorrhage. Acoustic neuroma is a tumor of the eighth cranial nerve, which is the nerve for hearing and balance. This is usually a slow growing tumor. Symptoms are hearing loss, tinnitus, vertigo and staggering. As the tumor grows, pressure on the fifth cranial nerve, the trigeminal, may cause pain on the opposite side of the face. Pituitary adenoma may cause symptoms related to mass or alterations in hormone production. Symptoms include headaches, visual disturbances and sleep, appetite and temperature problems. Tumors that alter hormonal production or function result in problems such as Cushing’s disease or problems related to sexual functioning, amenorrhea in females, or impotence in males. Nursing Assessment Includes headache, vomiting usually in the morning, often without nausea, loss of consciousness, vision problems such as diplopia and papilledema, tilting of the head. In infant, you will see widening sutures, increasing and tense fontanels. Supratentorial brain tumors lead to symptoms of personality changes and seizures. Infratentorial brain tumor symptoms include ataxia, visual disturbances, delayed or precocious puberty and growth failures. Diagnostics Include CT scan provides information relating to size and density of lesion. MR is useful in detecting small tumors and lesions in the brain stem. EEG detects abnormal brain waves in areas affected by a tumor. Computer assisted stereotactic biopsy is used to detect deep lesions. Cerebral angiography visualizes cerebral blood vessels. Medical Intervention Includes surgery, chemotherapy, radiation and drug therapy. Drug therapy includes corticosteroids to reduce inflammation and reduce edema; osmotic diuretics to decrease the water content in the brain; Mannitol to decrease ICP; anticonvulsants such as Dilantin to prevent and treat seizures and analgesics such as intrathecal or epidural morphine. Nursing Diagnosis • Self-care deficit related to loss or impairment of motor and sensory function and decreased cognitive abilities • Altered nutrition, less than body requirements, related to anorexia due to treatment effects, malabsorption, and decreased nutritional intake. • Anxiety related to anticipation of death, uncertainty and changes in lifestyle. Nursing Interventions


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