The nurse is monitoring a 7-year-old child post-surgical ...

[robinn137]

The nurse is monitoring a 7-year-old child post-surgical resection of an infratentorial brain tumor. Which vital sign findings indicate Cushing's triad?
 
  a. Increased temperature, tachycardia, tachypnea
  b. Decreased temperature, bradycardia, bradypnea
  c. Bradycardia, hypertension, irregular respirations
  d. Bradycardia, hypotension, tachypnea

Question 2

Which position should the nurse place a 10-year-old child after a large tumor was removed through a supratentorial craniotomy?
 
  a. On the inoperative side with the bed flat
  b. On the inoperative side with the head of bed elevated 20 to 30 degrees
  c. On the operative side with the bed flat and pillows behind the head
  d. On the operative side with the head of bed elevated 45 degrees

[katara]

Answer to Question 1

ANS: C
Cushing's triad is a hallmark sign of increased intracranial pressure (ICP). The triad includes bradycardia, hypertension, and irregular respirations. Increased or decreased temperature is not a sign of Cushing's triad.

Answer to Question 2

ANS: B
If a large tumor was removed, the child is not placed on the operative side because the brain may suddenly shift to that cavity, causing trauma to the blood vessels, linings, and the brain itself. The child with an infratentorial procedure is usually positioned on either side with the bed flat. When a supratentorial craniotomy is performed, the head of bed is elevated 20 to 30 degrees with the child on either side or on the back. In a supratentorial craniotomy, the head elevation facilitates CSF drainage and decreases excessive blood flow to the brain to prevent hemorrhage. Pillows should be placed against the child's back, not head, to maintain the desired position.

[robinn137]

Thank you

[katara]

Happy to help you