Essential postoperative nursing management of a child after ...

[mynx]

Essential postoperative nursing management of a child after removal of a brain tumor includes which nursing care?
 
  a. Turning and positioning every 2 hours
  b. Measuring all fluid intake and output
  c. Changing the dressing when it becomes soiled
  d. Using maximum lighting to ensure accurate observations

Question 2

A 5-year-old child is being prepared for surgery to remove a brain tumor. Preparation for surgery should be based on which information?
 
  a. Removal of the tumor will stop the various signs and symptoms.
  b. Usually the postoperative dressing covers the entire scalp.
  c. He is not old enough to be concerned about his head being shaved.
  d. He is not old enough to understand the significance of the brain.

[onowka]

Answer to Question 1

ANS: B
After brain surgery, cerebral edema is a risk. Careful monitoring is essential. All fluids, including intravenous antibiotics, are included in the intake. Turning and positioning depend on the surgical procedure. When large tumors are removed, the child is usually not positioned on the operative side. The dressing is not changed. It is reinforced with gauze after the amount of drainage is marked and estimated. A quiet, dimly lit environment is optimum to decrease stimulation and relieve discomfort such as headaches.

Answer to Question 2

ANS: B
The child should be told what he will look and feel like after surgery. This includes the anticipated size of the dressing. The nurse can demonstrate on a doll the expected size and shape of the dressing. Some of the symptoms may be alleviated by removal of the tumor, but postsurgical headaches and cerebellar symptoms such as ataxia may be aggravated. Children should be prepared for the loss of their hair, and it should be removed in a sensitive, positive manner if the child is awake. Children at this age have poorly defined body boundaries and little knowledge of internal organs. Intrusive experiences are frightening, especially those that disrupt the integrity of the skin.