Create a clinical nursing (not medical)How do you assess a client when the nurse suspects the onset of CVA? Provide discharge information for a client with mild TBI. Discuss surgical management of brain tumors.

Disorders of the Central Nervous System

Postoperative complications of a craniotomy

A craniotomy is one of the most common surgical procedures in the neurology unit. The procedure involves temporary surgical removal of the bone flap or part of the skull. The process is done for various reasons, such as removing a brain tumor or correcting a trauma under the dome. Although the system helps in the management of head conditions, the system has some complications that can lead to death if not identified and managed. Nurses, radiologists, and other team members working in the neurological unit should assess the patient post-operatively to detect any complications and manage them appropriately. MRI and CT scans should be done on a patient after undergoing craniotomy to see any abnormal findings post-craniotomy (Ignatavicius, Workman, & Rebar, 2017). The main complications that can occur to a patient after craniotomy include hemorrhage, cerebral edema, tension pneumocephalus, increased intracranial pressure, wound infection, and bone flap infection. Do you need urgent assignment help ? Reach out to us. We endeavor to assist you the best way possible.

Bleeding below the skull and in the brain is the most common complication of craniotomy. After the surgery, the blood vessels under the head and in the brain may rupture and continue bleeding (Ignatavicius, Workman, & Rebar, 2017). The wound may result in more bleeding under the skull, leading to the accumulation of blood in the brain. Continued bleeding leads to increased intracranial pressures, which destroys the brain cells. Cerebral edema is also a complication where fluid accumulates in the brain. The effect of fluid accumulation is intracranial pressure that affects the surrounding organs (Ignatavicius, Workman, & Rebar, 2017). The patient with hemorrhage, cerebral edema, and intracranial pressure after craniotomy, in most cases, presents with loss of consciousness. The nurse should always assess the patient’s level of consciousness to detect the effect of bleeding after the surgery (Ignatavicius, Workman, & Rebar, 2017). Taking vital signs also helps assess the patient to see issues such as bleeding in the brain.

Tension pneumocephalus is another neurosurgical emergency complication in the neurology unit that occurs after a craniotomy. With tension pneumocephalus, there is a massive impact on the brain parenchyma, which affects the patient’s brain (Lonjaret et al., 2017). During surgery, air may be introduced in the subdural space, which affects the brain. Post-craniotomy, the patient may present with cardiac arrest, severe restlessness, loss of consciousness, and neurological deficits. Pressure on the brain also causes tension pneumocephalus (Lonjaret et al., 2017). The accumulation of fluid and bleeding after the surgery leads to intracranial pressure, which may introduce air bubbles in the subdural space, leading to tension pneumocephalus. Patients with increased intracranial pressure may present with hydrocephalus. The most common sign of increased intracranial pressure is headache (Lonjaret et al., 2017). The patient may also present with signs and symptoms such as restlessness. However, some intracranial pressure and brain edema may reduce with time.

Wound and bone infections are also common after craniotomy. Some microorganisms may invade the wound, leading to disease of the bone and the condition of the damage. Therefore, the nurses should assess the patient for any sign of infection (Lonjaret et al., 2017). The patient is usually placed on antibiotics after the surgery to prevent the risk of diseases (Lonjaret et al., 2017). Taking vital signs such as temperature helps detect disease where the temperature may be elevated. Ideally, the healthcare team in the neurological unit should be aware of the complications and have strategies to deal with the difficulties to save lives. Radiologists should always be around to take MRI and CT scans, which help detect some of the problems and damage.

References

Ignatavicius, D. D., Workman, M. L., & Rebar, C. (2017). Medical-Surgical Nursing-E-Book: Concepts for Interprofessional Collaborative Care. Elsevier Health Sciences.

Lonjaret, L., Guyonnet, M., Berard, E., Vironneau, M., Peres, F., Sacrista, S., … & Geeraerts, T. (2017). Postoperative complications after craniotomy for brain tumor surgery. Anaesthesia Critical Care & Pain Medicine, 36(4), 213-218.