I.

Objectives of the study

General Objectives:
This case study aims to:
Identify a patients health care status
Gain more understanding about the patients condition
Establish plans to meet the actual and potential needs of the patient
Specific Objectives:
To be more oriented to health
To identify the pathophysiologic process responsible for oncologic disorder.
Describe brain tumor and their classification, clinical manifestations, diagnosis and
medical and nursing management.
To provide an individualized plan of care for the patient
To deliver specific nursing interventions to address the needs of the patient
To evaluate the effectiveness of the care plans
II.

Introduction
Definition of the case

A brain tumor is a growth of abnormal cells inside the brain. Most brain tumors that
children get are called primary brain tumors, meaning that they originated in the brain and did
not spread from somewhere else. Tumors might be localized, remaining in one area, or they
might be invasive, spreading into nearby tissues. Tumors are also categorized as benign (noncancerous) or malignant (cancerous). However, it is difficult to call any brain tumor "benign",
because all can cause serious problems.
There are two major types of brain tumor: primary brain tumors and secondary brain
tumors. Primary brain tumors arise from cells normally found in and around the brain.
Secondary brain tumors (also called brain metastases) arise from the spread of cancer from
another part of the body (e.g. lung cancer, breast cancer, skin cancer such as malignant
melanoma). Secondary brain tumors are more common than primary brain tumors.
Tumors can destroy brain cells directly, or they can indirectly cause damage, through these
mechanisms:

causing inflammation

compressing (squeezing) other parts of the brain as the tumor grows

causing generalized swelling of the brain, called cerebral edema

causing increased intracranial pressure (the pressure inside the skull)

Brain tumors are classified by where they are in the brain, what kind of tissue they are
composed of, whether they are benign or malignant, and many other factors. Some tumors tend
to be hereditary, running in families. Other types, such as craniopharyngioma , seem to be
congenital, developing before birth. Ultimately, the cause of most brain tumors is not known.
Incidence and Prevalence
Brain tumors can occur at any age. Tumors of the central nervous system (brain and
spinal cord) make up about 20 percent of all childhood cancer cases, which makes it second in
number only to leukemias. The annual incidence of brain tumors in children under the age of 15
is about 3 per 100,000. More than 1,200 new cases of brain tumor occur each year.
The incidence of many tumors varies with the age of the patient. For example, gliomas
account for 75 percent of brain tumors diagnosed in children, but only 45 percent in adults.
Retinoblastoma is the only form of brain tumor that is commonly seen in the first year of life.
Symptoms
The symptoms of a brain tumor depend upon several factors, including the specific site of the
tumor, the type of tumor, and the age and health of the patient. Symptoms might include the
following:

headache

vomiting

personality or behavior changes

emotional instability or rapid emotional changes

intellectual decline

seizures

facial paralysis

eye abnormalities or double vision

reduced level of consciousness or decreased alertness

weakness or lethargy

III.

general ill feeling or malaise

swallowing difficulty

impaired sense of smell

uncontrollable movement

hand tremor

confusion

Personal Data
Name of Patients:

Ms. X

Age:

45 years old

Gender:

Female

Address:

Bonbon, Aloguinsan, Cebu

Civil status:

Married

Nationality:

Filipino

Religion:

Roman Catholic

Birthday:

August 23, 1970

Highest Educational Attainment:

High School graduate

Occupation:

House wife

Source of Income:

Self employed

Source of Information:

Eldest sister

Rank of Family:

6th daughter

Attending Physician:

Dr. Limbaga

Chief Complaint:

Tremor

Date of admission:

February 05, 2016

Initial diagnosis:

Infected wound parieto occipital area S/P

Craniotomy, excision of parieto occipital
Ependymoma

Operations:

Debridement and suturing of infected wound

parieto occipital

Present Health Status:

A case of Ms. X , 45 years old, female, a Roman Catholic, under supervision of Dr.
Limbaga was admitted for the second time in VSMMC due to tremor.
Patient lying on bed, unconscious, unresponsive, with on ongoing # 14 PNSS 1L @
30gtts/min, hooked @ the left metacarpal area infusing well, with NGT attached to left nares
and tracheostomy to T-piece @ 4L/min, with the initial vital sign of T-36.6 C, P-84bpm, R24cmp, BP- 180/130.

Patient X was admitted at Vicente Soto Memorial Medical Center, January 06, 2016 after
being diagnosed to have brain tumor. The patient was submitted to a brain surgery. The surgery
was a success, no complication was noticed, and so she was able to be discharged from the
hospital.
But after one month watery secretion was noticed at her surgery wound. So she was again
admitted to the hospital, February 05, 2016 diagnosed for infection. Last April 08, 2016 they
were about to be discharge from the hospital but the patient was diagnosed to suffer from
pneumonia.
Thus patient X still confined at hospital mentioned above.
Past Health Status:
Patient X is chronically suffering from hypertension as verbalized by the SO. She is not
suffering from any other major ailment in the past.

Family Health History (Genogram)

6
1

Legend:

- FATHER

- PATIENT (6TH DAUGTHER)

- MOTHER

- HPN

1 - SISTER BROTHER

3-

3rd BROTHER

- ALIVE and WELL

- 2nd SISTER

2
4-

4TH SISTER

7-

7TH SISTER

9TH SISTER

- CANCER

- DECEASED
5 SISTER
- 5TH
8

- 8TH BROTHER

- 10TH BROTHER
1