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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.
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cerebral
ischemia 24-36 Post-op craniotomy care |
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After _________ surgery, pt is placed on his back or side, HOB elevated 30 degree and head on pillow.
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supratentorial
Post-op craniotomy care |
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After __________ surgery, pt is kept flat on one side (off the back) with head on a small, firm pillow.
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infratentorial
Post-op craniotomy care |
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After craniotomy, how do you Regulate temperature?
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monitoring temperature,
removing blankets, applying ice bag to axilla and groin, hypothermia blankets. |
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How do you Improve gas exchange after a craniotomy and what do you need to look out for?
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pneumonia is common
nurse assesses for signs of infection turn pt q2 hours suctioning with cautions to prevent increase of ICP. |
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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. |
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How do you enhance self-image after a craniotomy?
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encourage patient to express any frustration about any change in appearance.
Head covering with turban or wig until hair grows. |
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What are some types of complications that you as a nurse need to watch out for after a craniotomy?
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increased ICP
bleeding F and E disturbances infection DI and SIADH CSF leak |
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When can you resume PO fluids after a craniotomy?
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When the gag reflex and swallowing reflex have returned (usually 24 hrs)
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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?
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Meningitis, call the doctor
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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?
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because this can be due to CSF trickling down the throat, advice patient to avoid coughing, sneezing, or nose blowing.
Go call the doctor. |
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What are the s/s of an intramedullary tumor?
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Shooting pains
Weakness Loss of reflexes above the tumor level to progressive loss of motor fx Paralysis |
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What is a spinal tumor called when its w/in spinal cord?
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intramedullary
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What is a spinal tumor called when its w/in or under spinal dura?
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Extramedullary-intradural
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What is a spinal tumor called when its outside the dural membrane?
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Extramedullary-extradural lesions
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What are some generic s/s of spinal cord tumors?
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Sharp pain
Weakness Loss of reflexes Loss of motor fx Paralysis Sensory deficits |
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How do you tx a spinal cord tumor?
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Surgical intervention
Chemo Radiation |
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What are the nursing responsibilies for a pre-op spinal surgery pt?
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Aware of neuro changes
Pain control Help w/ ADLs Assess for motor weakness, muscle wasting, spacity, sensory changes, bowel/bladder dysfunction, potential respiratory problems |
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What are the nursing responsibilies for a post-op spinal surgery pt?
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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 |