A nurse is reviewing a prescription for dexamethasone (Decadron) with a client who has an expanding brain tumor. Which of the following are appropriate statements by the nurse? (Select all that apply.)

“It is given to reduce swelling of the brain.”

“You will need to monitor for low blood sugar.”

“You may notice weight gain.”

“Tumor growth will be delayed.”

“It can cause you to retain fluids.”

Answer and Explanation

Correct Answer : A,C,E

Dexamethasone (Decadron) is a corticosteroid commonly prescribed to clients with expanding brain tumors to reduce cerebral edema. By decreasing swelling and inflammation, it helps relieve intracranial pressure and associated neurological symptoms such as headache or vomiting. Corticosteroids, however, are associated with metabolic and fluid retention side effects that require client education. Monitoring and teaching about weight gain, fluid retention, and hyperglycemia are essential to safe therapy.

Rationale for correct answers:

A. “It is given to reduce swelling of the brain.” Dexamethasone decreases cerebral edema and relieves symptoms of increased ICP. This is the primary therapeutic purpose in brain tumor management.

C. “You may notice weight gain.” Corticosteroids can increase appetite and cause fat redistribution, resulting in weight gain. This is a common, expected side effect of therapy.

E. “It can cause you to retain fluids.” Steroids promote sodium and water retention, which can lead to peripheral edema. Clients should be taught to monitor for swelling or sudden weight changes.

Rationale for incorrect answers:
B. “You will need to monitor for low blood sugar.” Dexamethasone can raise, not lower, blood glucose levels. Hyperglycemia is a more likely concern, especially in clients with diabetes.
D. “Tumor growth will be delayed.” Dexamethasone does not affect tumor growth; it only reduces surrounding edema. Definitive tumor treatment requires surgery, radiation, or chemotherapy.

Take home points

Dexamethasone reduces cerebral edema but does not shrink the tumor itself.
Weight gain, fluid retention, and hyperglycemia are key side effects requiring education.
Client teaching helps ensure early recognition of complications during corticosteroid therapy.

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Correct Answer is A

Explanation

Brain tumor location determines the type of neurological symptoms a client experiences. The frontal lobe is responsible for personality, judgment, voluntary motor control, and memory, so tumors here often cause behavioral changes, weakness, and cognitive deficits. Symptoms such as right-sided weakness indicate involvement of the motor cortex, while personality and memory changes reflect disruption of frontal lobe function. Recognizing these patterns assists in localizing brain tumors and guiding further evaluation.

Rationale for correct answer:

A. Frontal lobe: Controls personality, voluntary motor activity, and higher cognitive functions. Tumors here cause weakness, personality changes, and memory deficits consistent with the client’s presentation.

Rationale for incorrect answers:
B. Parietal lobe: Primarily involved in sensory interpretation and spatial awareness. Tumors here typically cause sensory loss or neglect rather than personality changes.
C. Occipital lobe: Responsible for vision and visual processing. While visual disturbances may occur, isolated occipital tumors would not cause personality changes or hemiparesis.
D. Temporal lobe: Involved in auditory processing and language interpretation. Tumors here are more likely to cause aphasia, auditory hallucinations, or memory issues without hemiparesis.

Take home points

Frontal lobe tumors often cause personality changes, cognitive deficits, and contralateral weakness.
Tumor location correlates closely with neurological presentation, guiding diagnostic evaluation.
Symptom mapping helps clinicians localize and prioritize brain imaging studies.

A. keep the head of the bed flat. B. elevate the head of the bed to 30 degrees. C. maintain patient on the left side with the head supported on a pillow. D. use a continuous-rotation bed to continuously change patient position.

Correct Answer is B

Explanation

Positioning is a critical intervention for clients with increased intracranial pressure (ICP) to promote venous drainage from the brain without compromising cerebral perfusion. Elevating the head of the bed (HOB) to 30 degrees optimizes venous outflow, reduces ICP, and helps prevent further cerebral edema. Extreme flexion or rotation of the head should be avoided, as these positions can impede venous return and worsen pressure. Proper positioning is a first-line nursing intervention in ICP management.

Rationale for correct answer:
B. Elevate the head of the bed to 30 degrees: This position facilitates cerebral venous drainage while maintaining adequate cerebral perfusion. It is the recommended standard for clients with increased ICP.

Rationale for incorrect answers:

A. Keep the head of the bed flat: Flat positioning can increase ICP by reducing venous outflow from the brain. This position is generally avoided unless specifically ordered for procedures like lumbar puncture.

C. Maintain patient on the left side with the head supported on a pillow: Lateral positioning may cause neck flexion and impaired venous return. Side-lying does not optimize ICP reduction.

D. Use a continuous-rotation bed: Frequent or continuous rotation can cause spikes in ICP. This therapy is reserved for preventing pulmonary complications, not for ICP management.

Take home points

HOB elevated 30 degrees is the safest and most effective position for ICP reduction.
Avoid neck flexion, extreme rotation, or flat positioning, as these can worsen ICP.
Positioning is a noninvasive, first-line nursing intervention to protect the brain.

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A nurse is reviewing a prescription for dexamethasone (Decadron) with a client who has an expanding brain tumor. Which of the following are appropriate statements by the nurse? (Select all that apply.)

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A nurse is reviewing a prescription for dexamethasone (Decadron) with a client who has an expanding brain tumor. Which of the following are appropriate statements by the nurse? (Select all that apply.)