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25 Cards in this Set
- Front
- Back
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Cerebral Angiography Patient Care Prep |
Contrast Precautions NPO 4-6 hours pre-test Dentures and hearing aids must be removed Teach: -Head will be immobilized during procedure -Do not move -You will feel warm/hot sensation when the dye is injected -You will be able to talk to the Dr. and let him know if you are in pain or have concerns |
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Cerebral Angiography Follow-up Interventions: |
Check dressing for bleeding/swelling around site (if bleeding occurs – apply pressure and call Dr.!) -Apply ice pack to site -Keep extremity straight and immobilized -Maintain pressure dressing for 2 hours -Check extremity for adequate circulation (color, temp, pulses) -Assess VS and Neuro checks -Increase fluid intake |
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CT Scan Patient Care Prep |
Contrast Precautions Determine if pt is claustrophobic (sedation may be needed) Teach: -Remove hairpins, wigs, etc. -Inform that scanner may make noise or knocking sounds – must remain completely still (should take < 5 min) -Pt will be able to communicate with technician -Pt may report metallic taste |
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CT Scan Follow-up |
Monitor the pt for a delayed allergic response if contrast was used. |
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MRI Patient Care Prep |
No metal objects may enter the MRI room – ask about any metal implants Check with radiologist about tattoos and entering the room |
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MRI Follow up |
No special procedure or follow-up care is needed |
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PET Scan Patient Care Prep |
NPO 4-12 hours pre test -Procedure will take 2-3 hours, may be blindfolded or have ear plugs & will be asked to perform certain mental functions -Withhold caffeine, alcohol, and tobacco for 24 hrs -Do NOT give insulin prior to (pts will have test before it is due) -Do not give any meds that alter glucose metabolism |
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PET Scan follow Up |
The radioisotope is eliminated in the urine, No precautions required, Encourage pt to increase fluid intake |
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EEG Patient Care Prep |
Thoroughly explain procedure to pt: -Pt is placed on a reclining chair or bed -15-20 electrodes are attached to the scalp -Pt must lie still -Test takes 40-60 min, and is not dangerous -Withhold CNS depressants or stimulants, anticonvulsants, caffeine -Wash hair morning of test, remove hair pins |
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EEG Follow Up |
Wash hair after test to remove electrode glue |
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Lumbar Puncture Patient Care Prep |
Explain the procedure: -Some discomfort may be felt for anesthetic, and pain in legs when spinal needle inserted -Position pt in fetal, side-lying position to separate vertebrae and move spinal nerve roots away from area being accessed -Remind them to remain still -Instruct pt to notify Dr. if shooting pain or tingling is felt -Relax as much as possible so pressure reading is accurate -3-5 test tubes of CSF is taken |
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Lumbar Puncture Follow Up |
Slight pressure is applied and an adhesive bandage strip is placed over site Obtain VS and neuro checks Bedrest and remain flat Increase fluid intake Monitor for complications ** ↑ICP: -severe HA -N/V -Photophobia -change in LOC Observe insertion site for leakage Provide drug for HA |
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Treatment Brain Tumor |
Mostly radiation or surgical removal (sometimes chemo) |
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Craniotomy Approach: |
tentorium= duramater layer that separates the cerebrum and cerebellum |
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Supratentorial |
in cerebrum = top of head |
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Infratentorial |
in cerebellum and brainstem = back of head Balance, equilibrium, ataxia, clumsy, uncoordinated |
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Transphenoidal or pituitary tumor |
thru the sphenoid sinus (incision = upper lip/thru the nose) –they will have nasal sling under nose, nose will be packed |
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Nursing Care |
Frequent VS/Neuro checks Q15min, and hourly I&O (looking for complications r/t ADH) |
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Position |
:Supra or trans = HOB up Always correlated with CPP Bc if HOB goes up and BP drops perfusion will drop too |
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Infra |
24 hours FLAT/SIDE, HOB up after that |
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MEDS |
Steroids ** to reduce edema/inflammation, Keep on anti-seizures, Stool softeners(NO STRAINING If pt strains, ICP ↑) Coughing, sneezing, Valsalva maneuver (forced exhale with closed airway) =bad too Proton-pump inhibitors or H2 blockers/ reduce acid from steroids & bc they are in a stressful state –curling’s stress ulcers, Pain=NO NARCOTICS!!!!!!!! Must be able to assess mental status Tylenol is sufficient |
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Keep NPO 24-hrs |
so no post-op nausea |
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HYPERVENTILATION r/t to ICP |
If pt is starting to develop increased ICP >20 and they’re on a ventilator you should hyperventilate them and blow off CO2, bc it causes vasoconstriction (monro-kelli: change in blood may give more room for pressure). But has to be short term bc it could cause ischemia Keep CO2 on the low side (35-36) |
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Monitor for complications |
Drainage: bloody but not much, NO CSF –if u suspect, test with glucose strip** |
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Labs: |
CBC(shouldn’t be much blood loss, but look at H&H, WBC) Electrolytes (complication for DI and SIADH) –SODIUM, ABGs –CO2** We want it on the LOW side of normal range 35-45 |
