Adult Nursing Nervous System Lec.2 Yaseen M.M.
اورام اﻟﺪﻣﺎغ Brain Tumors
اﻟﺘﻌﺮﯾﻒ Definition Brain Tumor
A brain tumor is a localized intracranial lesion that occupies
space within the skull.
ورم اﻟﺪﻣﺎغ ھﻮ اﺻﺎﺑﺔ ﻣﻮﺿﻌﯿﺔ داﺧﻞ اﻟﻘﺤﻒ )اﻟﺠﻤﺠﻤﺔ (Skull-واﻟﺘﻲ ﺗﺸﻐﻞ
ﻣﺴﺎﺣﺔ ﻣﻦ اﻟﺪﻣﺎغ واﻟﻤﻔﺮوض ﻋﺪم وﺟﻮدھﺎ ﻓﻲ اﻟﺤﺎﻻت اﻟﻄﺒﯿﻌﯿﺔ ) ﺗﻔﺮض ﻧﻔﺴﮭﺎ(
A variety of physiologic changes result, causing any or all of
the following pathophysiologic events:
اﻟﻌﺪﯾﺪ ﻣﻦ اﻟﺘﻐﯿﯿﺮات اﻟﻔﺴﻠﺠﯿﺔ ) اﻟﻮظﯿﻔﯿﺔ ( ﺗﺤﺪث ﻧﺘﯿﺠﺔ ﻟﻮﺟﻮد اﻟﻮرم ﻓﻲ اﻟﺪﻣﺎغ
و ﺗﺤﺪث اﺣﺪ او ﻛﻞ اﻻﻋﺮاض اﻟﻔﺴﻠﺠﯿﺔ اﻟﺘﺎﻟﯿﺔ
•Increased intracranial pressure (ICP) and cerebral edema
-1ارﺗﻔﺎع اﻟﻀﻐﻂ داﺧﻞ اﻟﻘﺤﻒ ووذﻣﺔ اﻟﻤﺦ ) واﻟﺘﻲ ھﻲ ﺗﺮاﻛﻢ اﻟﻤﯿﺎه ﻓﻲ داﺧﻞ
أو ﺧﺎرج اﻟﺨﻼﯾﺎ ﻓﻲ اﻟﻤﺦ(.
• Seizure activity and focal neurologic signs
-2ﻧﻮﺑﺔ ﻣﻦ اﻟﺼﺮع واﻟﺘﻲ ھﻲ ارﺗﺠﺎف اﻟﺠﺴﻢ ﺑﺸﻜﻞ ﻻ اردي ﺑﺴﺒﺐ اﯾﻌﺎزات
ﻣﺘﻜﺮرة وﻛﺜﯿﺮة ﻣﻦ اﻟﺪﻣﺎغ ﺑﺸﻜﻞ ﻏﯿﺮ ﻣﻨﺘﻈﻢ وﺑﺪن داﻋﻲ او ﺣﺎﺟﺔ اﻟﻰ ذﻟﻚ و
ﻛﺬاك ﻋﻼﻣﺎت ﺑﻮرﯾﺔ ﺗﺪل ﻋﻠﻰ ﺧﻠﻞ ﻓﻲ اﺣﺪ اﻻﻋﺼﺎب او ﺗﺎﺛﺮ اﻟﻨﺨﺎع اﻟﺸﻮﻛﻲ
• Hydrocephalus
-3اﺳﺘﺴﻘﺎء اﻟﻤﺦ )اﻟﺮأس( ھﻮ ﺗﺮاﻛﻢ اﻟﺴﺎﺋﻞ اﻟﻨﺨﺎﻋﻲ ﻓﻲ ﺑﻄﯿﻨﺎت اﻟﺪﻣﺎغ واﻟﺘﺴﺒﺐ
ﺑﺰﯾﺎدة ﺣﺠﻤﮫ ،وﺑﺎﻟﺘﺎﻟﻲ زﯾﺎدة اﻟﻀﻐﻂ ﻋﻠﯿﮫ.
• Altered pituitary function
-4ﺗﻐﯿﺮ ﻓﻲ وظﺎﺋﻒ اﻟﻐﺪة اﻟﻨﺨﺎﻣﯿﺔ )اﻓﺮاز اﻟﮭﺮﻣﻮﻧﺎت .......اﻟﺦ (
Primary brain tumors originate from cells and structures
within the brain.
اورام اﻟﺪﻣﺎغ اﺑﺘﺪاءً ﺗﻨﺒﻊ ﻣﻦ ﺧﻼﯾﺎ و اﻧﺴﺠﺔ و ﺗﺮاﻛﯿﺐ اﻟﻤﺦ
Secondary, or metastatic, brain tumors develop from
structures outside the brain (lung, breast, lower gastrointestinal
Adult Nursing Nervous System Lec.2 Yaseen M.M.
tract, pancreas, kidney, and skin (melanomas) and occur in 20%
to 40% of all patients with cancer. Brain tumors rarely
metastasize outside the CNS.
اﻣﺎ اﻻورام اﻟﺜﺎﻧﻮﯾﺔ ﯾﻜﻮن ﻣﻨﺒﻌﮭﺎ ﻣﻦ ﺧﺎرج اﻟﻤﺦ وﺗﺼﻞ ﻟﻠﻤﺦ ﻧﺘﯿﺠﺔ ﻟﺒﺮوزھﺎ
اﻟﺦ ( واﻧﺘﺸﺎرھﺎ..... اﻟﺜﺪي و اﻟﺒﻨﻜﺮﯾﺎس، وﺗﺸﻜﻠﮭﺎ ﻓﻲ ﻋﻀﻮ اﺧﺮ ﻓﻲ اﻟﺠﺴﻢ )اﻟﺮﺋﺔ
ﻋﺒﺮ اﻻﻧﺴﺠﺔ او اﻟﺪورة اﻟﺪﻣﻮﯾﺔ او اﻟﺠﮭﺎز اﻟﻠﻤﻔﺎوي وﻣﻤﻜﻦ ﻻورام اﻟﻤﺦ اﻻﻧﺘﺎر اﻟﻰ
ﺧﺎرﺟﮭﺎ ﻟﻸﻋﻀﺎء اﻻﺧﺮى
The highest incidence of brain tumor occurs between 50-
70 years. It causes death by:
( ﺳﻨﺔ وﺗﺴﺒﺐ اﻟﻮﻓﺎة70- 50) اﻟﻨﺴﺒﺔ اﻻﻋﻠﻰ ﻻورام اﻟﺪﻣﺎغ ﺗﺤﺪث ﻓﻲ اﻟﻔﺌﺔ اﻟﻌﻤﺮﯾﺔ
ﻻﺣﺪى اﻟﺴﺒﺒﯿﻦ
1. The impairment of vital functioning by direct
involvement.
ﺧﻠﻞ اﻻﻋﻀﺎء اﻟﺤﯿﻮﯾﺔ ﻓﻲ اﻟﺠﺴﻢ وﻓﻘﺪاﻧﮭﺎ ﻟﻮظﺎﺋﻔﮭﺎ ﻣﺜﻞ اﻟﺮﺋﺔ واﻟﻜﻠﯿﺘﯿﻦ-1
(اﻟﺦ....
2. Increase I.C.P.
ارﺗﻔﺎع ﺿﻐﻂ اﻟﻘﺤﻒ وﺗﺎﺛﯿﺮھﺎ اﻟﻤﺒﺎﺷﺮ ﻋﻠﻰ وظﯿﻔﺔ اﻟﺪﻣﺎغ-2
General sign and symptoms اﻻﻋﺮاض واﻟﻌﻼﻣﺎت اﻟﻌﺎﻣﺔ
1. Head ache: not persist and occur in early morning and
increase in the intensity during strain such as coughing,
sneezing or sudden movement.
ﯾﺤﺪث ﻓﻲ اﻟﺼﺒﺎح اﻟﺒﺎﻛﺮوﯾﺰداد ﻣﻊ اﻟﻀﻐﻂ ﻛﺎﻟﺴﻌﺎل، ﺻﺪاع ﻏﯿﺮ ﻣﺴﺘﻤﺮ-1
(IICP ) واﻟﻌﻄﺎس او اﻟﺤﺮﻛﺔ واﻟﻨﺸﺎط اﻟﻤﻔﺎﺟﺊ ﺗﻤﺎﻣﺎ ﻣﺜﻞ
2. Vomiting: seldom related to food intake, is usually due to
irritation of the vagal centers in the medulla.
Adult Nursing Nervous System Lec.2 Yaseen M.M.
ﻓﮭﻲ ﻋﺎدة ﺗﺤﺪث ﺑﺴﺒﺐ، اﻟﺘﻘﯿﺆ واﻟﺘﻲ ﻧﺎدرا ﻣﺎ ﯾﻜﻮن ﺑﺴﺒﺐ ﺗﻨﺎول اﻟﻄﻌﺎم-2
( اﻟﻤﺴﺆل ﻋﻦ ﻣﻌﻀﻢMedulla) ﺗﺨﺮش او ﺗﺎﺛﺮ ﻣﺮﻛﺰ اﻟﻌﺼﺐ اﻟﺘﺎﺋﮫ ﻓﻲ
اﻟﻔﻌﺎﻟﯿﺎت اﻟﺤﯿﻮﯾﺔ ﻓﻲ اﻟﺠﺴﻢ
3. Visual Disturbances. Papilledema (edema of the optic
nerve) associated with visual disturbances such as
decreased visual acuity, diplopia (double vision), and
visual field deficits.
اﺿﻄﺮاب و اﺧﺘﻼل اﻟﻨﻈﺮﺑﺴﺒﺐ وذﻣﺔ اﻟﻌﺐ اﻟﺒﺼﺮي واﻟﺘﻲ ﺗﺆدي اﻟﻰ-3
( وازدواج اﻟﺮؤﯾﺔ وﻧﻘﺺ او ﺗﺤﺪدE.chart ﻧﻘﺼﺎن ﺣﺪة اﻟﻨﻈﺮ)ﻓﺤﺺ
( درﺟﺔ180 ﺣﻘﻞ وﻣﺠﺎل اﻟﺮؤﯾﺔ )اﻗﻞ ﻣﻦ
LOCALIZED SYMPTOMS Depends on the site of the tumor
ﺣﺴﺐ ﻣﻜﺎن اﻟﻮرم: اﻻﻋﺮاض اﻟﻤﻮﺿﻌﯿﺔ
1. An occipital lobe tumor produces visual manifestations:
contralateral hemianopsia (visual loss in half of the visual
field) and visual hallucinations.
ھﺬا اﻟﺠﺰء اﻟﻤﺴﺆول ﻋﻦ اﻟﺮؤﯾﺔ ﯾﺤﺪث ﻓﯿﮭﺎ اﻋﺮاض ﻓﻘﺎن ﻧﺼﻒ ﻣﺠﺎل اﻟﺮؤﯾﺔ
ﺑﺎﻹﺿﺎﻓﺔ اﻟﻰ اﻟﮭﻠﻮﺳﺔ )ﺗﺨﯿﻞ ( اﻟﺒﺼﺮﯾﺔ
2.A cerebellum tumor causes
1. Dizziness,
2. Staggering gait with a tendency to fall toward the side of
the lesion.
3. Ataxic (muscle in coordination).
4. Nystagmus (involuntary rhythmic eye movements),
usually in the horizontal direction.
اﻟﻤﺸﯿﺔ اﻟﺘﻌﺜﺮﯾﺔ ﯾﻌﻨﻲ اﻟﻤﺸﻲ اﻟﻤﺎﺋﻞ ﻟﻠﺴﻘﻮط اﻟﻰ-2 ، اﻟﺪوﺧﺔ-1 ورم اﻟﻤﺨﯿﺦ ﯾﺴﺒﺐ
ﻋﺪم اﻟﺘﻨﺎﺳﻖ ﻓﻲ اﻟﻤﺸﻲ وﺣﺘﻰ اﻟﺨﻄﻮات ) ﻣﻜﺎن وﺿﻊ-3 ﺟﮭﺔ اﻟﻮرم ﻣﻦ اﻟﺪﻣﺎغ
ﺣﺮﻛﺔ ﻣﺴﺘﻤﺮة ﻟﻠﻌﯿﻦ-4 اﻟﻘﺪم (ﻓﻲ اﻣﺎﻛﻦ ﻣﺤﺘﻠﻔﺔ ﺑﺴﺒﺐ ﺿﻌﻒ ﺗﻨﺴﯿﻖ اﻟﻌﻀﻼت
ﺑﺪون ﺳﯿﻄﺮة ﻋﺎدة ﻣﻦ اﻟﯿﻤﯿﻦ اﻟﻰ اﻟﯿﺴﺎر وﺑﺎﻟﻌﻜﺲ
3.A frontal lobe tumor frequently produces
1. Personality disorders. اﺿﻄﺮاب اﻟﺸﺨﺼﯿﺔ
Adult Nursing Nervous System Lec.2 Yaseen M.M.
2. Changes in emotional state and behavior. ﺗﻐﯿﺮ اﻟﺤﺎﻟﺔ اﻟﻌﺎطﻔﯿﺔ
(ﻣﺜﻞ اﻟﻔﺮح او اﻟﺤﺰن واﻟﺴﻠﻮﻛﯿﺔ )ﻋﻠﻰ ﻏﯿﺮ اﻟﻤﻌﺘﺎد
3. Lose of memory or disturbed memory. ﻓﻘﺪان واﺿﻄﺮاب
اﻟﺬاﻛﺮة ﻣﺜﻞ اﻟﻨﺴﯿﺎن
4. An uninterested mental attitude. The patient often
becomes extremely untidy and careless and may use
obscene language. ﯾﺼﺒﺢ اﻟﻤﺮﯾﺾ ﻣﮭﻤﻼ ﻟﻨﻔﺴﮫ وﯾﺘﻔﻮه ﺑﻜﻼم ﻓﺎﺣﺶ
5. Tinnitus and vertigo. اﻟﻄّﻨﯿﻦ
(Tinnitus) ... .ھﻮ اﺣﺴﺎس ﻏﯿﺮ ﻣﻮﺿﻮﻋﻲ ﺑﺴﻤﺎع ﺿﺠﯿﺞ ﻓﻲ اﻷذﻧﯿﻦ
ﯾﻤﻜﻦ أن ﯾﻈﮭﺮ ھﺬا اﻟﻄﻨﯿﻦ ﺑﺸﻜﻞ ﻣﺘﻮاﺻﻞ أو ﻋﻠﻰ ﻓﺘﺮات ﻣﺘﻘﻄﻌﺔ
دوار او ﻓﻘﺪان اﻟﺘﻮازنvertigo و
6. progressive nerve deafness (eighth cranial nerve
dysfunction).
اﻟﻄﺮش )اﻟﺼﻤﻢ( او ﻓﻘﺪان اﻟﺴﻤﻊ اﻟﻤﺘﺰاﯾﺪ ﺗﺪرﯾﺠﯿﺎ ﺑﺴﺒﺐ ﻓﻘﺪان وظﯿﻔﺔ اﻟﻌﺼﺐ
اﻟﺜﺎﻣﻦ
7. Numbness and tingling of the face and the tongue
اﻟﺨﺪر)ﻓﻘﺪان اﻟﺸﻌﻮر( و اﻟﺘﻨﻤﻞ )اﺣﺴﺎس ﻣﺆﻟﻢ( ﻓﻲ اﻟﻮﺟﮫ واﻟﻠﺴﺎن
8. Tumor of temporal lobe: Impairment of speech اﺿﻄﺮاب
اﻟﻜﻼم ﻣﺜﻞ ﺻﻌﻮﺑﺔ ﻟﻔﻆ اﻟﺤﺮوف او ﺗﻜﻤﻠﺔ اﻟﻜﻼم
9. Tumor of parietal lobe: Numbness then weakness in the
opposite side of the body, unable to know the thing
(object) by touching (hypoesthesia), and aphasia
(inability to speak coherently) in patient with Rt. Hand.
ﺧﺪر وﺿﻌﻒ ﻓﻲ اﻟﺠﺎﻧﺐ اﻟﻤﻘﺎﺑﻞ اﻟﻤﻌﺎﻛﺲ ﻟﺠﮭﺔ اﻟﻮرم وﻋﺪم اﻟﻘﺪرة ﻋﻠﻰ ﺗﻤﯿﯿﺰ
اﻻﺷﯿﺎء ﺑﺎﻟﻠﻤﺲ وﻋﺪم اﻟﻘﺪرة ﻋﻠﻰ اﻟﻜﻼم ﺑﺸﻜﻞ ﻣﺘﻤﺎﺳﻚ ﺧﺎﺻﺔ ﻓﻲ اﻟﻤﺮﯾﺾ اﻟﺬي
ﯾﺴﺘﺨﺪم اﻟﯿﺪ اﻟﯿﻤﻨﻰ
Adult Nursing Nervous System Lec.2 Yaseen M.M.
Nursing Intervention
1. Monitor neurological status as ordered. Report
changes promptly. Deteriorating status may signify
increased ICP.
ﻣراﻗﺑﺔ و ﺗﻘﯾﯾم اﻟﺣﺎﻟﺔ اﻟﻌﺻﺑﯾﺔ ﻟﻠﻣرﯾض ﻣن ﺧﻼل ﺗوﺛﯾق اي اﻋراض ﺗﺿﮭرﻋﻠﯾﮫ
وﻣﻌﺎﻟﺟﺔ وﺗﻐﯾﯾر ﻣﺳﺑﺑﺎت زﯾﺎدة اﻟﺿﻐط اﻟﻘﺣﻔﻲ ﻣﺛل اﻟﺳﻌﺎل واﻻﻣﺳﺎك واﻟﻌطﺎس
2. Position patient with the head of the bed at 30
degrees or higher, unless ordered, to promote
venous drainage and minimize increases in
intracranial pressure. The exception to this is patients
who have had a chronic subdural hematoma
removed, who must remain flat.
درﺟﺔ ﻟﺗﺳﮭﯾل رﺟوع اﻟدم ﻓﻲ اﻻوردة وﻋدم اﺣﺗﺑﺎﺳﮭﺎ30 وﺿﻊ اﻟﻣرﯾض ﺑزاوﯾﺔ
ﻓﻲ اﻟﻣﺦ وﺑﺎﻟﺗﺎﻟﻲ ﺗﺧﻔﯾف اﻟﺿﻐط ﻋﻠﻰ اﻟدﻣﺎغ
3. Implement seizure precautions because the patient is
at risk for seizures due to cerebral edema.
اﺧذ اﻻﺣﺗﯾﺎطﺎت اﻟﻼزﻣﺔ ﻋﻧد ﻻﺣﺗﻣﺎل ﺣدوث اﻟﻧوﺑﺔ ﻣﺛل اﺑﻌﺎد اﺛﺎث او ادوات
ﺟﺎرﺣﺔ وﺗﮭﯾﺋﺔ اﻻوﻛﺳﺟﯾن و ادوات ﻓﺗﺢ اﻟﻣﺟرى اﻟﮭواﺋﻲ وﺻوﻧدة اﻻدرار
4. Use caution to protect many monitoring systems for
example:. The patient may have an intracranial
monitor in place following surgery to monitor
intracranial pressure. or central venous pressure
catheters to monitor fluid status.
اﺳﺗﺧدام اﻻﺣﺗﯾﺎطﺎت ﻟﺣﻣﺎﯾﺔ اﻟﻘﺛﺎطر )اﻻدوات اﻟطﺑﯾﺔ اﻟﺑﻼﺳﺗﯾﻛﯾﺔ اﻟداﺧﻠﺔ ﻟﻠﺟﺳم
وﺟزء ﻣﻧﮭﺎ ﺧﺎرج اﻟﺟﺳم ﺑﺎﺧﺗﻼف اﺳﻣﺎﺋﮭﺎ واﻣﺎﻛﻧﮭﺎ ﻣن اﻟﺟﺳم
5. Urinary catheters are used during the immediate
postoperative period to accurately monitor fluid
balance.
اﺳﺗﺧدام ﺻوﻧدة )ﻗﺛطرة ( اﻻدرار ﺑﻌد اﻟﻌﻣﻠﯾﺔ ﻟﻣراﻗﺑﺔ ﺗوازن اﻟﺳواﺋل ﻓﻲ اﻟﺟﺳم
6. Monitor dressings for drainage. Drainage that is
blood tinged in the center with a yellowish ring
Adult Nursing Nervous System Lec.2 Yaseen M.M.
around it may be CSF leakage. A suspected CSF
leak should be reported to the RN or physician
immediately.
ﻣراﻗﺑﺔ اﻟﺿﻣﺎد ﺧﺎﺻﺔ اذا وﺟد دم ﻓﻲ اﻟﺿﻣﺎد ﻣﺧﻠوط ﺑﻠون اﺻﻔر ﻋﻠﻰ ﺷﻛل ﺣﻠﻘﻰ
( و ﻋﻠﯾﮫ ﯾﺳﺗﻠزم اﺧﺑﺎرCSF) ﻓﺎﻧﮫ ﻣﺣﺗﻣل ان اﻟﻠون اﻻﺻﻔر ھو ﺗﺳرب ﺳﺎﺋل اﻟدﻣﺎغ
. اﻟطﺑﯾب واﻟﻣﻣرض اﻟﻣﺳؤول ﻓﻲ اﻟﺣﺎل
7. Monitor for rise in temperature, purulence at incision
site, and increase in white cell count. These are signs
of infection and should be reported immediately.
ﻣراﻗﺑﺔ ﻋﻼﻣﺎت اﻻﻟﺗﮭﺎب ﻣﺛل ارﺗﻔﺎع اﻟﺣرارة ووﺟود اﻟﻘﯾﺢ او) اﻟﺟراﺣﺔ( و زﯾﺎدة
WBC
8. Use strict aseptic technique for all care of the
incision, dressing, and monitoring equipment sites to
reduce risk of infection.
wound dressing (اﺗﺑﺎع ﺗﻘﻧﯾﺔ اﻟﺗﻌﻘﯾم ﻋﻧد اﻟﻌﻧﺎﯾﺔ ﺑﺎﻟﺟرح) ﺷق اﻟﻌﻣﻠﯾﺔ
9. Offer a turban, scarf, or hat if the patient desires to
help conceal a shaved head. اﻋطﺎء ﺷﯾﻠﺔ او رﺑطﺔ واﻟﯾﺷﻣﺎغ
ﻟﻐطﺎء اﻟراس
10. Patients are likely aware of nurses’ nonverbal
behavior.اﻟﻣرﯾض ﯾﺗواﺻل ﺑﺎﻻﺷﺎرات ﻣﻊ اﻟﻣﻣرض وﻟﯾس ﺑﺎﻟﻛﻼم
11. Allow the patient to express his or her feelings if
desired. Talking may help the patient work through
feelings, but it should not be forced.
اﻟﺳﻣﺎح وﻣﺳﺎﻋدة اﻟﻣرﯾض ﻟﻠﺣدﯾث ﻋن ﻣﺎ ﯾﺷﻌر وﯾﻔﻛر ﺑﮫ ﻻن ذﻟك ﯾﺳﺎﻋد ﻋﻠﻰ
اﻟﺗﺧﻠص ﻣن اﻟﺷد اﻟﻧﻔﺳﻲ واﻟﻘﻠق واﻟﺷﻌور ﺑﺎﻻرﺗﯾﺎح ﻣن اﺟﺎﺑﺎت اﻟﻣﻣرض
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Meningitis اﻟﺗﮭﺎب اﻟﺳﺣﺎﯾﺎ
Meningitis is an inflammation of the lining around the brain
and spinal cord caused by bacteria or viruses.
اﻟﺗﮭﺎب اﻻﻏﺷﯾﺔ اﻟﻣﺣﯾطﺔ ﺑﺎﻟدﻣﺎغ واﻟﻧﺧﺎع اﻟﺷوﻛﻲ ﺑﺳﺑب اﻟﺑﻛﺗرﯾﺎ او اﻟﻔﯾروﺳﺎت
Adult Nursing Nervous System Lec.2 Yaseen M.M.
