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19 Cards in this Set

  • Front
  • Back
Maintaining ________ tissue perfusion: essential as slight decrease of O2 may cause cerebral ________. Some degree of cerebral edema often peaks after ___ to ___ hours after surgery.
cerebral
ischemia
24-36

Post-op craniotomy care
After _________ surgery, pt is placed on his back or side, HOB elevated 30 degree and head on pillow.
supratentorial

Post-op craniotomy care
After __________ surgery, pt is kept flat on one side (off the back) with head on a small, firm pillow.
infratentorial

Post-op craniotomy care
After craniotomy, how do you Regulate temperature?
monitoring temperature,
removing blankets,
applying ice bag to axilla and groin,
hypothermia blankets.
How do you Improve gas exchange after a craniotomy and what do you need to look out for?
pneumonia is common
nurse assesses for signs of infection
turn pt q2 hours
suctioning with cautions to prevent increase of ICP.
How do you manage sensory deprivation after a craniotomy?

:
periorbital edema is common due to prone position during surgery,

applying cold compresses will reduce edema.

If the periorbital edema increases significantly, the surgeon is notified because it may indicate that a post-op clot is developing and increased ICP.
How do you enhance self-image after a craniotomy?
encourage patient to express any frustration about any change in appearance.

Head covering with turban or wig until hair grows.
What are some types of complications that you as a nurse need to watch out for after a craniotomy?
increased ICP
bleeding
F and E disturbances
infection
DI and SIADH
CSF leak
When can you resume PO fluids after a craniotomy?
When the gag reflex and swallowing reflex have returned (usually 24 hrs)
You have a post-op craniotomy pt who is c/o a sudden discharge from the incision, what could this mean? what should you do?
Meningitis, call the doctor
Post-op craniotomy pt complains of salty taste in the back of the throat, what could this be? What should you do? WHat should you tell the pt to do?
because this can be due to CSF trickling down the throat, advice patient to avoid coughing, sneezing, or nose blowing.

Go call the doctor.
What are the s/s of an intramedullary tumor?
 Shooting pains
 Weakness
 Loss of reflexes above the tumor level to progressive loss of motor fx
 Paralysis
What is a spinal tumor called when its w/in spinal cord?
intramedullary
What is a spinal tumor called when its w/in or under spinal dura?
Extramedullary-intradural
What is a spinal tumor called when its outside the dural membrane?
Extramedullary-extradural lesions
What are some generic s/s of spinal cord tumors?
Sharp pain
Weakness
Loss of reflexes
Loss of motor fx
Paralysis
Sensory deficits
How do you tx a spinal cord tumor?
Surgical intervention
Chemo
Radiation
What are the nursing responsibilies for a pre-op spinal surgery pt?
 Aware of neuro changes
 Pain control
 Help w/ ADLs
 Assess for motor weakness, muscle wasting, spacity, sensory changes, bowel/bladder dysfunction, potential respiratory problems
What are the nursing responsibilies for a post-op spinal surgery pt?
 Watch neuro
 Do neuro checks
 Assess sensory fx
 Motor
 strength
 VS
 Manage pain
 Keep bed flat initially
 Turn patient using log-rolling (side-lying most comfy)
 Pillow btwn knees
 Watch for potential complication
• Asymmetric chest moevemtn
• Abdominal breathing
• Abnormal breath sounds
• Deep breath and cough