Glioblastoma: 5 Nursing Diagnosis Care Plans

What is Glioblastoma?

Glioblastoma is a type of brain cancer. It’s one of the most aggressive and serious forms of cancer that affects the brain.

It starts in the glial cells, which are cells that help keep neurons in place and functioning well. Because glioblastoma grows quickly, it requires immediate and aggressive treatment.

How Do You Get It?

The exact cause of glioblastoma is not well-understood.

However, it’s not contagious, meaning you can’t catch it from someone else. Some factors like age, exposure to radiation, and family history might increase the risk, but there’s no sure way to know who will get it.

Signs and Symptoms

People with glioblastoma often experience:

• Headaches
• Memory problems
• Changes in behavior
• Trouble speaking
• Weakness on one side of the body

Diagnosis

To figure out if someone has glioblastoma, doctors may perform tests like:

• MRI (Magnetic Resonance Imaging)
• CT Scan (Computerized Tomography)
• Biopsy (taking a small piece of the tumor to look at under a microscope)

Treatment

Because glioblastoma is aggressive, treatment usually starts right away and might include:

• Surgery to remove as much of the tumor as possible
• Radiation therapy to kill cancer cells
• Chemotherapy to stop cancer cells from growing

What’s the Outlook?

Glioblastoma is hard to treat fully because it grows so quickly. Even with treatment, it often comes back. The goal of treatment is often to slow down the tumor’s growth and ease symptoms to improve quality of life.

Glioblastoma Nursing Diagnosis and Care Plan

1. Risk for Ineffective Cerebral Tissue Perfusion related to tumor growth as evidenced by altered mental status and focal neurological deficits.

Goals and Outcomes

• Goal 1: Improve cerebral tissue perfusion within 48 hours.
  • Outcome: Patient will show stable vital signs and improved neurological function.
• Goal 2: Prevent complications related to impaired cerebral perfusion.
  • Outcome: Patient will remain free from seizures and additional neurological impairments.

Interventions and Rationale

Interventions	Rationale
Monitor vital signs every 4 hours.	Vital signs can give clues about cerebral perfusion status.
Keep the head elevated 30-45 degrees.	Helps in improving blood flow to the brain.
Administer medications as prescribed.	To improve blood flow and reduce intracranial pressure.
Monitor for neurological changes.	Early detection of changes can prevent complications.
Use pulse oximeter to check oxygen levels.	Ensures adequate oxygenation, necessary for brain function.
Administer oxygen as ordered.	To improve oxygen saturation and promote better brain function.
Encourage leg exercises.	To improve overall circulation and prevent clots.
Measure ICP if applicable.	To monitor for changes that could affect cerebral perfusion.
Monitor urine output.	Poor output may indicate decreased perfusion.
Apply sequential compression devices.	To promote circulation and prevent clots.

2. Acute Pain related to tumor growth as evidenced by verbal reports and facial grimacing.

Goals and Outcomes

• Goal 1: Achieve pain control within 24 hours.
  • Outcome: Patient will report a pain level below 3 on a scale of 0-10.
• Goal 2: Minimize side effects of pain medication.
  • Outcome: Patient will show no signs of medication-related complications like constipation.

Interventions and Rationale

Interventions	Rationale
Assess pain level using pain scale.	To determine the effectiveness of pain management.
Administer pain medications as ordered.	To relieve pain.
Monitor for side effects of medications.	To prevent and manage medication-related complications.
Apply a cold or warm compress.	To provide non-pharmacological pain relief.
Use distraction techniques.	To shift focus away from pain.
Re-assess pain after interventions.	To evaluate effectiveness of treatment.
Teach relaxation techniques.	To promote natural methods of pain relief.
Position the patient comfortably.	To minimize discomfort and promote relaxation.
Monitor vital signs after medication.	To check for effects or complications of medication.
Encourage deep breathing exercises.	To help with relaxation and possibly alleviate pain.

3. Anxiety related to diagnosis and prognosis as evidenced by restlessness and excessive questioning.

Goals and Outcomes

• Goal 1: Reduce anxiety level within 24 hours.
  • Outcome: Patient will report feeling more relaxed and less anxious.
• Goal 2: Improve coping mechanisms.
  • Outcome: Patient will identify and use two new ways to cope with stress.

Interventions and Rationale

Interventions	Rationale
Provide a calm environment.	To help the patient relax.
Listen actively to concerns.	Listening can help in alleviating anxiety.
Educate about the disease and treatment.	Knowledge may reduce uncertainty and anxiety.
Encourage the use of coping mechanisms.	To promote mental wellness.
Administer anti-anxiety medication as ordered.	To provide fast relief from acute anxiety.
Promote deep breathing exercises.	Helps in relaxation.
Use simple and clear language.	To prevent misunderstandings that could heighten anxiety.
Involve family in discussions.	Support from loved ones can help reduce anxiety.
Monitor for changes in vital signs.	Anxiety can affect heart rate and blood pressure.
Set realistic goals.	Helps in focusing and reducing anxiety.

4. Impaired Physical Mobility related to neurological impairments as evidenced by unsteady gait and difficulty in moving.

Goals and Outcomes

• Goal 1: Improve physical mobility within one week.
  • Outcome: Patient will be able to move with assistance and experience less difficulty in walking.
• Goal 2: Prevent injury associated with impaired mobility.
  • Outcome: Patient will remain free from falls or other injuries related to mobility for one week.

Interventions and Rationale

Interventions	Rationale
Assess mobility level daily.	To monitor any changes and adapt the care plan accordingly.
Use assistive devices like walkers.	To provide stability and prevent falls.
Monitor for signs of discomfort or fatigue.	To avoid overexertion, which could lead to injury.
Encourage assisted physical exercise.	To improve muscle strength and overall mobility.
Administer pain medications as necessary.	Pain can limit mobility, so managing it can improve movement.
Elevate limbs when resting.	To reduce swelling and improve circulation.
Teach proper lifting techniques.	To prevent injury when the patient is moving.
Keep frequently used items within reach.	To minimize the need for difficult movements.
Install grab bars in necessary areas.	To provide additional support and prevent falls.
Monitor for any signs of skin breakdown.	Immobility can lead to pressure sores or ulcers.

5. Impaired Verbal Communication related to brain tumor affecting speech centers as evidenced by slurred speech and difficulty forming words.

Goals and Outcomes

• Goal 1: Improve verbal communication within one week.
  • Outcome: Patient will be able to convey basic needs and wants more effectively.
• Goal 2: Facilitate alternative means of communication.
  • Outcome: Patient will be proficient in using at least one form of non-verbal communication.

Interventions and Rationale

Interventions	Rationale
Assess the level of communication difficulty.	To tailor interventions to the patient’s specific needs.
Use communication boards or apps.	To offer an alternative way to convey needs and wants.
Engage in speech therapy if advised.	To improve verbal communication skills.
Encourage short sentences or words.	To make communication less tiring and more effective.
Monitor for signs of frustration.	Frustration can make communication even more challenging.
Educate family on alternative communication methods.	To ensure effective communication even when nursing staff is not present.
Re-validate what the patient is trying to say.	To ensure understanding and prevent miscommunication.
Use simple and clear language.	To make it easier for the patient to understand.
Encourage regular rest periods.	To prevent fatigue which can further impair communication.
Offer a notepad and pen.	To enable written communication if verbal is too difficult.

With these nursing diagnoses, goals, and interventions, healthcare providers and family caregivers can offer comprehensive and effective care for patients with glioblastoma.

Conclusion

Glioblastoma is a serious and aggressive type of brain cancer. It requires prompt and specialized medical treatment. If you or someone you know has symptoms, it’s important to see a doctor right away for diagnosis and to start treatment

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References

https://pubmed.ncbi.nlm.nih.gov/30424920/