Nursing Care Plan for Brain Tumor (Intracranial Tumor)

Last updated: Saturday, April 6, 2013 - Save & Share - Leave a Comment

Brain Tumor

A brain tumor, or tumour, is an intracranial solid neoplasm, a tumor (defined as an abnormal growth of cells) within the brain or the central spinal canal.

A brain tumor begins when normal cells in the brain change and grow uncontrollably, forming a mass. A tumor can be benign (noncancerous) or malignant (cancerous). In general, primary CNS tumors do not spread outside of the CNS. Malignant brain tumors are further classified using a grade: low, intermediate, or high.

Brain tumors can occur at any age. The exact cause of brain tumors is not clear.
There most common type of primary brain tumors among adults are astrocytoma, meningioma, and oligodendroglioma.
The most common type of primary brain tumors in children are medulloblastoma, grade I or II astrocytoma, ependymoma, and brain stem glioma.

The most common symptoms of brain tumors include headaches; numbness or tingling in the arms or legs; seizures, memory problems; mood and personality changes; balance and walking problems; nausea and vomiting; changes in speech, vision, or hearing.

 

Assessment for Brain Tumor (Intracranial Tumor)

  1. Focal neurological disorders. In the frontal lobe, occurred personality disorders, affective disorders, the motor system dysfunction, seizures, aphasia. Precentral gyrus can be found on Jacksonian seizures. In the occipital lobe, visual disturbances, and headache. Temporal lobe can occur auditory hallucinations, visual or gustatory and psychomotor seizures, aphasia. In the parietal lobe can be found the inability to distinguish left – right, sensory deficit (contralateral).
  2. Increased ICT: lethargy, decreased HR, decreased level of consciousness, papilledema, projectile vomiting, seizures, changes in breathing patterns, changes in vital signs.
  3. Mental. Personality changes, depression, decreased memory and ability to make decisions.
  4. Pituitary dysfunction. Cushing’s syndrome, acromegaly, giantisme, hypopituitarism.
  5. Pain. Persistent headache.
  6. Seizure activity.
  7. Fluid status. Nausea and vomiting, decreased urine output, dry mucous membranes, decreased skin turgor, decreased serum sodium, BUN, Hb, Hct, hypotension, tachycardia, weight decreased.
  8. Psychosocial. Anger, fear, mourning and hostility.

 

Nursing Diagnosis for Brain Tumor (Intracranial Tumor)

1. Disturbed Body Image related to hair loss, and changes in the structure and function of the body.

2. Impaired Skin Integrity related to the effects of chemotherapy and radiation therapy.

3. Acute Pain related to severe headaches and side effects of treatment.

4. Risk for Fluid Volume Deficit related to the side effects of chemotherapy and radiation therapy.

 

Nursing Interventions for Brain Tumor (Intracranial Tumor)

1. Disturbed Body Image related to hair loss, and changes in the structure and function of the body.

Goal:
Patients express a positive self-image

Expected outcomes:
Patients received a change in body image.

Interventions:

1. Assess the patient’s reaction to body changes.
2. Observation of patient social interaction.
3. Maintain a therapeutic relationship with the patient.
4. Instruct the patient to open communication with health care or other important person.
5. Help patients find effective coping about body image.

Rational:

1. Determine the patient’s reaction to changes in body image.
2. Social withdrawal may occur due to rejection.
3. Facilitate a therapeutic relationship.
4. Expression of fears openly to reduce anxiety.
5. Help patients find coping strategies that can reduce anxiety and fear.

 

2. Impaired Skin Integrity related to the effects of chemotherapy and radiation therapy.

Goal:
Patient’s skin integrity is maintained

Expected outcomes:
Intact skin,
There is no redness or damage.

Interventions:

1. Assess skin integrity every 4 hours.
2. Keep skin clean and dry, use soap and water to bathe the patient.
3. Repositioning the patient every 2 hours.
4. Advise for fluid intake and adequate nutrition.

Rational:

1. Red, dry, and injuries can occur in the area of radiation, chemotherapy can cause rash, hyperpigmentation and hair loss.
2. Prevent skin damage.
3. Improve circulation and prevent pressure sores.
4. Dehydration and malnutrition may increase the risk of developing pressure sores.

 

3. Acute Pain related to severe headaches and side effects of treatment.

Goal:
The patient does not feel pain

Expected outcomes:
Reported no discomfort,
Not grimace, cry,
Vital signs within normal limits,
Participate in activities appropriately.

Interventions:

1. Assess the location, and duration of headache and pain in the incision every 2 hours.
2. Set giving analgesics / narcotics.
3. Give comfort to the patient.

Rational:

1. Sudden changes or severe pain may indicate increased ICT and should be reported to the doctor.
2. Giving narcotic, sedative effect.
3. Eliminating discomfort and anxiety.
4. Risk for Fluid Volume Deficit related to the side effects of chemotherapy and radiation therapy.

 

4. Risk for Fluid Volume Deficit related to the side effects of chemotherapy and radiation therapy.

Goal:
Adequate fluid balance can be maintained

Expected outcomes:
Intake and output balance,
Skin turgor and moist mucous membranes,
Serum electrolytes, Hb, Hct, and vital signs within normal limits

Interventions:
1. Skin turgor, mucous membranes, thirst, blood pressure, HR, monitor serum electrolytes, albumin and CBC.
2. Monitor intake and output.
3. Encourage adequate intake. Set intravenous fluids, appropriate orders.
4. Set antiemtek administration, appropriate orders.

rational:
1. Determine dehydration status.
2. Vomiting may occur in patients with chemotherapy and radiation therapy.
3. Help maintain adequate hydration.
4. Reduce nausea and vomiting.

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