OBJECTIVES General Objectives: After 1 week of holistic caring care, the patient and significant others will be able to acquire adequate knowledge, attitude and skills towards health promotion Specific Objectives: After 45 minutes of Nurse – Patient interaction, the patient and significant others will be able to: CONTENT METHODOLOGY EVALUATION


Define Craniotomy according to his level of understanding

Craniotomy: A craniotomy is the surgical removal of part of the bone from the skull to expose the brain. Specialized tools are used to remove the section of bone called the bone flap. The bone flap is temporarily removed, then replaced after the brain surgery has been performed.


2. Explain the Reasons of the Craniotomy procedure

A craniotomy may be performed to for a variety of reasons, including, but not limited to, the following:


• • • • • • • •

diagnosing, removing, or treating brain tumors clipping or repairing of an aneurysm removing blood or blood clots from a leaking blood vessel removing an arteriovenous malformation (AVM) - an abnormal mass of blood vessels (arteries and veins) draining a brain abscess - an infected pus-filled pocket repairing skull fractures repairing a tear in the membrane lining the brain (dura mater) relieving pressure within the brain (intracranial pressure) by removing damaged or swollen areas of the brain that may be caused by traumatic injury or stroke treating epilepsy - a neurological condition involving the brain that makes people more susceptible to seizures implanting stimulator devices to treat movement disorders such as Parkinson's disease or dystonia (a type of movement

Discussion with illustrations

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3. Enumerate the risks

they will be removed during a follow-up office visit. complications may occur. 5. If stitches or surgical staples are used. it is important to keep the incision clean and dry. Participation of patient and significant others cooperation in the activity given Verbalization of their understanding    . Cite precautions to prevent infection There may be other risks depending upon your specific medical condition. so they may or may not be valid risks for certain individuals: • • • • • memory problems speech difficulty paralysis abnormal balance or coordination coma 4. if the area of the brain that controls speech is operated on. Identify importance of Infection control and comfort measures: strict compliance to regimen  Once you are home. Perform techniques to you specific bathing instructions. Your physician will give 6. Be sure to discuss any concerns with your physician prior to the procedure.  You may shower and shampoo 3 to 4 days after surgery unless otherwise directed by your surgeon. If adhesive strips are used. but are not limited to.42 involved after craniotomy Risks of the Procedure As with any surgical procedure. they should be kept dry and generally will fall off within a few days. Demonstration The following additional complications are rare and generally relate to specific locations within the brain. the following: • • • • • • • • • • • infection hemorrhage (bleeding) thrombus (formation of blood clots) pneumonia (infection of the lungs) unstable blood pressure seizures muscle weakness brain swelling leakage of cerebrospinal fluid (the fluid that surrounds and cushions the brain) pneumonia (infection in the lungs) unstable blood pressure Discussion. Brain surgery risk is tied to the specific location in the brain that the operation will affect. Some more general complications include. For example. You may choose to wear a loose turban or hat over the incision. prevent infection infection control measures and comfort measures. then speech may be affected.

especially with deep breathing. The incision and head may ache. Special measures must be taken to protect the brain.  The head of your bed may be elevated to prevent swelling of your face and head. Take a pain reliever for soreness as recommended by your physician. with assistance at first. fumes. as your strength improves. Show positive response towards the activity  You will be advised to avoid exposure to upper respiratory infections (colds and flu) and irritants. or until you are able to get out of bed and move around. Some swelling is normal. and mobility. and exertion. Be sure to report any painful urination or other urinary symptoms that occur after the catheter is removed.  You will be encouraged to move around as tolerated while in bed and to get out of bed and walk around. Be sure to take only recommended medications and ask if you are unsure.43  You should not wear a wig until the incision is completely healed(about 3 to 4 weeks after surgery). such as a helmet or a temporary implant in the skull   5. and environmental pollution. and give you suggestions for exercises to do both in the hospital and at home. balance.  You will have a catheter in your bladder to drain your urine for a day or so.  You will be taught deep-breathing exercises to help re-expand the lungs and prevent pneumonia. such as tobacco smoke. A physical therapist (PT) may be asked to evaluate your strength. as these may . coughing.

 You may be instructed to avoid lifting heavy items for several weeks in order to prevent strain on your surgical incision. Asking questions when confused and participating in the activity.44 be signs of an infection that can be treated. . The patient and her significant others listen and cooperate with the discussion.

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