Brain Tumor & Renal

Calculi

Prepared by:
The Boyz
Definition of Brain Tumor
 An abnormal growth of cells within the brain
or inside the skull, which can be cancerous
(malignant) or non-cancerous (benign) and
described as any intracranial tumor created
by abnormal and uncontrolled cell division.
Risk Factor
Types of Brain Tumor
 Benign brain tumors do not contain cancer
cells:
◦ Benign tumors can be removed and they often grow
back.
◦ The border or edge of a benign brain tumor can be
clearly seen.
◦ Cells from benign tumors do not attack tissues
around them or stretch to other parts of the
body but can push on sensitive areas of the
brain and effect serious health problems.
◦ Benign brain tumors are sometimes life
threatening and may grow to be malignant.
Cont…
 Malignant brain tumors contain cancer
cells:
◦ Malignant brain tumors are generally more serious
and often life threatening.
◦ They are likely to grow rapidly and mob or attack
the surrounding healthy brain tissue.
◦ Cancer cells may separate from a malignant brain
tumor and reach to other parts of the brain,
spinal cord, or even to other parts of the body
called metastasis.
◦ A malignant tumor does not extend into healthy
tissue.
◦ The tumor may be contained inside a layer of
tissue or the bones of the skull or another
structure in the head may discharge it called
encapsulated.

Sign & Symptom
 Headaches
 Nausea or vomiting
 Changes in speech, vision, or hearing
 Problems balancing or walking
 Changes in mood, personality, or ability to
concentrate
 Problems with memory
 Seizures or convulsions
 Numbness or tingling in the arms or legs

Test
 MRI
 Neurologic exam
 CT scan
 Physical exam
 Angiogram
 Skull x-ray -
 Spinal tap- a sample of cerebrospinal fluid
 Myelogram - X-ray of the spine
 Biopsy

Method of Treatment
 Surgery - Surgery to open the skull is called
a craniotomy
 Radiation therapy(radiotherapy ) - uses high-
energy rays to kill tumor cells
 Chemotherapy - the use of drugs to kill
cancer cells and used to treat brain tumors
be given by mouth or by injection.

Nursing Intervention I
 “ Acute pain related to tumor and increase in intracranial pressure ”


 Goal - Patient’s pain is decreased and looked healthy



 Nursing Intervention


ü Assess the level of pain and patient complaint

 Rationale: To know abnormality and plan further interventions
ü Positioning patient by raise the head of the bed slightly
 Rationale: To decreased pressure in intracranial pressure

ü Reduced noise and bright lights in the room

 Rationale: To promote patient comfort
ü Administer medication as ordered by doctor such as amoxycillin
 Rationale: To decreased pain


 Evaluation - Patient pain is reduced and looked comfortable


Nursing Intervention II
“ Anxiety related to unknown future following surgery ”
Goal – To reduce patient anxiety

 Nursing Intervention
ü Assess the level of patient’s anxiety
 Rationale: To plan further intervention
ü Educate and explain about the surgery
 Rationale: Patients can understand about the procedure
ü Encourage patient and family to verbalize feelings, question and
fears
 Rationale: Help reduces anxiety and fear
ü Involved family members
 Rationale: To promote support to patient


 Evaluation - Patients anxiety reduced and understanding the surgery

procedure

Nursing Intervention III
“ Risk for infection due to disease process ”
Goal – To decreased risk of infection


 Nursing Intervention
ü Assess the IV insertion sites for redness, swelling, drainage, and pain.
 Rationale: Redness, swelling, drainage and pain are signs and symptom of
infections.
ü Assess for signs and symptom of meningitis.
 Rationale: Patient present with fever, headache and photophobia.
ü Monitor laboratory reports for increased WBC count.
 Rationale: To monitor increasing risk of infection.
ü Use strict aseptic technique when changing dressings.
 Rationale: To maintain sterility and prevent infections.
ü Keep the client’s hands away from drains and dressings.
 Rationale: Dirty hands can encourage infections to the dressing sites.
ü Administer prescribed antibiotic such as amoxycillin
 Rationale: Antibiotic used to kill microphages and reduce infections.

 Evaluation – The risk of infection to patient decreased.
Definition of Renal Calculi
 It is solid concretions (crystal
aggregations) formed in the kidneys from
dissolved urinary minerals.

Etiology of Renal Calculi
1. Composed of calcium oxalate crystals
- When the amount of calcium intake decreases,
the amount of oxalate easy to absorption
into the bloodstream increases and then
excreted into the urine by the kidney
2. Composed of uric acid

- a persistent undue urine acidity

Sign & Symptoms
 Colicky pain - the worst pain
 Hematuria - blood in the urine
 Pyuria - pus (white blood cells) in the urine.
 Dysuria - burning on urination when passing
stones.
 Oliguria - reduced urinary volume caused by
obstruction of the bladder or urethra by stone
 Abdominal distension.
 Nausea/vomiting
 Fever and chills.
 Loss of appetite
 Loss of weight

Diagnostic Test
 X-ray
 CT scans
 Ultrasound
 Urine C & S
 Blood FBC
 24 hours urine collection
Treatment
qMedication such as
- Analgesia such as morphine sulfate ( to
relieve pain and reduce uteral spasm )
- NSAID such as suppository ( may reduce the
amount of narcotic analgesia required for
acute renal colic)
qSurgery
- Lithotrispy– using sound or shock waves to
crush stone.

Prevention
 Drinking enough water
 A diet low in protein, nitrogen and sodium
intake.
 Restriction of oxalate rich foods, such as
chocolate plus maintenance of an adequate
intake of dietary calcium.
 Taking drugs such as thiazides, potassium
citrate, magnesium citrate and allopurinol,
depending on the cause of stone formation.
 Some fruit juices, such as orange, blackcurrant,
and cranberry, may be useful for lowering the
risk factors for specific types of stones.
 Avoidance of cola beverages.
 Avoiding large doses of vitamin C.

Nursing Intervention I
“ Fluid deficit related to disease process ”
Goal : Pt’s can increase fluid volume and maintain

electrolyte in the body.

ü N.I : Assess patient condition especially symptom of
dehydration.
 R : To indentify level of dehydration and to plan
further intervention.
ü N.I : administer IV fluid as ordered by the doctor.
 R : To replace loss fluid in the body.
ü N.I : Educate the patients about the needed balanced
fluid intake.
 R : To increase PT knowledge.
Evaluation : Patient look healthy, comfortable and no

sign and symptom of dehydration.

Nursing Intervention II
“ Pain related to disease process ”
Goal : Pt can decrease pain and look healthy.
üN.I : Assess patient level of pain using pain
scale.
 R : To identify level of pain and to plan further
intervention.
üN I : administer pain killer such as menfenic
acid as order by doctor.
 R : to reduce pain and Pt look comfortable.
üN I : advice Pt to restrict fluid intake as order
by doctor
 R : by reducing urination it will reduce pain.


Evaluation – pain patient decrease


Thank You…