Pediatric Nursing Demystified

Parietal lobe:

• Seizures.


• Sight disturbances result in visual field defect.


• Sensory loss: Unable to identify object placed in hand without looking.
  Temporal lobe:


• Seizures


• Taste or smell hallucinations


• Auditory hallucinations


• Depersonalization


• Emotional changes


• Visual field defects


• Receptive aphasia


• Altered perception of music

Test Results

MRI with gadolinium (contrast) defines tumor location, size.

CT shows characteristic appearance of meningioma.

Angiography shows blood flow to the area; some tumors displace ves-

sels as they grow.

Treatment

Chemotherapeutic agents alone, in combination with radiation and surgery.

May be given orally, intravenously, or through an Ommaya reservoir.

Drugs are chosen based on cell type:

• Carmustine, lomustine, procarbazine, vincristine, temozolomide,
  erlotinib, gefitinib
  Irradiation of the area to decrease tumor size.
  Craniotomy to remove the tumor, if appropriate, depends on location,
  size, primary site of cancer, and number of tumors. Some patients may
  have several small, scattered tumors, making surgery impractical.
  Administer glucocorticoid to reduce swelling or inflammatory response
  within confined space inside skull (no room to expand; bone does not give):


• Dexamethasone
  Administer osmotic diuretic to reduce cerebral edema:


• Mannitol
  Administer anticonvulsant to reduce chance of seizure activity:


• Phenytoin, phenobarbital, carbamazepine, divalproex sodium, val-
  proic acid, levetiracetam, lamotrigine, clonazepam, topiramate, etho-
  suximide
  Administer mucosal barrier fortifier to reduce risk of gastric irritation:


• Sucralfate
  Administer H 2 receptor antagonists to reduce risk of gastric irritation:


• Ranitidine, famotidine, nizatidine, cimetidine

(^216) Pediatric Nursing Demystified