BRAIN TUMOURS.pptx description pathophysiology

Healthcare

1. BRAIN TUMOURS

2. BRAIN TUMORS Are the most common forms of solid tumors and second most common type of cancer in children. The prognosis depends on the location and extent of tumor . They can either be benign or malignant.

3. Classifications Brain tumors in children are classified in several different ways: By type of cells involved - can be classified by the type of cell of origin and it includes; ependymomas , medulloblastomas and gliomas . Location of the tumor - some common location of brain tumor includes; cerebellum, brain stem and cerebral hemispheres. They can either be primary or secondary tumors .

4. Risk factors Family history Genetic conditions Exposure to radiations Age

5. Pathophysiology Though the cause of brain tumors are unknown its effects are predictable. As the tumor grows within the cranium, it exerts pressure on the brain tissues surrounding it. Tumors may compress vital structers in the brain, block cerebrospinal fluid flow or cause edema in the brain. The result is an increased in intracranial pressure. Presenting symptoms vary according to the location and type of tumor .

6. types Astrocytsoma : these tumors arise from astrocytes and they can be low or high grade. Slow course with insidious onset. Medulloblastomas : they occur in the cerebellum and are highly malignant. Half occur in children< 6 years old. Seeds on the CNS pathways. Ependymomas : these tumors arises from floor of fourth ventricle. Often causes hydrocephalus. C raniopharyngiomas : these tumors arises from embryonic tissue that is left over from the development of the brain. Brain stem glioma : arises from brain stem. Affects the cranial nerve function. Resistant to chemotheraphy .

7. Signs and symptoms Increased intracranial pressure. Headaches Vomiting Seizures Balance problems Visual changes Personality changes Difficulty in feeding

8. Diagnostic assessments and findings Neurological exam : this evaluation of child’s nervous system. Imaging tests : CT scan, MRI scans,PET scan used to visualize the brain and detect abnormalities. Biopsy : helps determine the type of tumor and its grade. Lumber puncture : helps determine if there are any cancerous cells in the CSF. Blood tests : to check certain tumor markers or genetic mutations associated with brain tumors . Electroencephalogram(EEG): measures electrical activities of the brain.

9. Management of a child with brain tumors Goals; Relieve pain Reduce anxiety Minimise the side effects and complication Medical management Surgery; mainly craniotomy Chemotheraphy ; cytotoxic agents such as methotrexate are used to destroy brain tumors . Radiation theraphy ; use of radiations to kill cancer cells.

10. Con’t Anticonvulsants; phenobarbital administered to control convulsions. Analgesics given to reduce pain . Morphine . (IV) 0.05 - 0.2 mg/kg/ dose  (Max: 2 - 4 mg). Q2-4. (PO) 0.2 - 0.5 mg  or pethidine   0.5-2mg per kilogram of body weight   Antibiotics administered, ceftaxidine 50mg/kg

11. Nursing management • Rehabilitation after treatment to help with speech, physical appearance, hearing, reflexes and body changes. •Nutrition- encourage the child to take small frequent meals and if the child is still breastfeeding educate the mother to breast feed little by little to prevent vomiting. Encourage the children to take soft foods and NG tube can be inserted when the kid cannot eat. BMI and MUAC should be measured to help monitor the nutritional status of the child to ensure the child remains healthy.

12. •Provide toys or dolls that the child will play with to divert their concentration on pain. •Educate the mother on some expected side effects of chemotherapy like nausea and vomiting, alopecia, bleeding and muscle wasting among others. •During surgery or wound dressing maintain aseptic technique to prevent infection. •Allay the anxiety of the mother and the child by explaining the progress of the child to the mother and some expected outcomes.

13. •Assess the child’s vitals especially temperature which can help you know when the child has an infection especially after surgery. However BP, pulse and respirations should also be taken and recorded. •Assess for signs of increased intracranial pressure by measuring the head circumference as well as other signs like seizures and convulsions to ensure they are managed early enough before developing further complications.

14. •Incases of increased ICP encourage bed rest and decrease lighting in the room and position the child in a side lying position to prevent injury when a seizure occurs. •Neurological exam should be performed to help detect any changes in vision, balance coordination, ataxia and paralysis. •physiotherapy can help incase of paralysis

15. complications Hydrocephalus Brain stem herniation Mental retardation Memory loss Paralysis Hearing and vision loss

16. Nursing diagnosis Impaired cognitive function related to the presence of a brain tumor , as evidenced by difficulty with memory, attention, or decision-making   Imbalanced nutrition: less than body requirements related to decreased appetite, nausea, vomiting, or other gastrointestinal symptoms associated with the brain tumor or its treatment. Risk for ineffective cerebral tissue perfusion related to the presence of the brain tumor , which can lead to decreased oxygenation and blood flow to the brain

17. Disturbed sleep pattern related to the impact of the brain tumor or its treatment on the patient's sleep quality . Risk for impaired communication related to the location of the brain tumor and its impact on speech, language, or other communication skills . Risk for injury related to seizures or motor deficits associated with the brain tumor .   Anxiety related to the diagnosis of a brain tumor and its potential impact on the patient's health and well-being.