Eliciting Problems and Execution of Nursing Interventions among Patients Subjected to Craniotomy for Tumour Excision at Kovai Medical Center and Hospital, Coimbatore

INTRODUCTION: There is no machine more complex and extraordinary than the human body among the body systems, the nervous system is often viewed as an intimidating, complex and poorly understood system. A brain tumor is a collection or mass of abnormal cells in brain. Skull encloses brain, is very rigid. Any growth inside the skull and restricted space can cause problems. Brain tumors can be cancerous or benign. When tumors begin to grow, it can cause increase pressure inside skull to elevate ICP. This can cause brain damage, and life-threatening. The worldwide incidence rate of primary malignant brain and other CNS tumors was 3.4 per 100,000 in 2012. The incidence rates were higher in more developed countries 5.1 per 100,000 than in less developed countries 3.0 per 100,000. Approximately 4000 patients in the Unites States are diagnosed with glioblastoma each year. The median age at diagnosis is 65 years. The main risk factors for glioblastoma extremely rare genetically inherited syndromes, including Li- Fraumeni syndrome and Turcot’s syndrome, and exposure to ionizing radiation. Objective : The main aim of the study was to Elicit the problems of patients undergoing craniotomy, execute the nursing interventions on patients subjected to craniotomy for tumour excision, evaluate the nursing interventions execute on patients undergoing craniotomy and find out the association between selected demographic variables with elicited problems. Design: Case study design. Setting: Kovai Medical Center and Hospital, Coimbatore. Sample size: 20 adult patient with craniotomy for tumour excision. Conceptual Frame Work: Modified Ida Jean Orlandos Nursing Process Theory (1961).Data Collection Procedure: After obtaining ethical clearance from concerned authority, verbal consent from the participants demographic profile was collected. Post operative problems were identified by using assessment tool. Results: The problems elicited on brain tumour with craniotomy surgeries were headache 85% (n=17), pain 60% (n=12), hyperglycemia 40% (n=8), nausea 35% (n=7), hypertension 30% (n=6), hyperthermia, muscle weakness, and vomiting was elicited among 25% (n=5) samples. Similar value 15% (n=3)was found among anaemia, and increased ICP. The problems such as constipation and seizure had the similar 2(10%) occurence. least 5% (n=1)of them had aphasia, diplopia, epidural heamatoma, hypokalemia, CSF leakage, metabolic acidosis, tachypnea and tachycardia. The “t” value 11.96 for the mean difference between the GCS score on admission and the number of elicited problems is higher than the table value and it is significant at 0.000 level. Conclusion: Majority of the male underwent craniotomy due to meningioma and had right parietal type of craniotomy. Majority of the problems arised at the initial 48hours of post operative period. Prompt nursing assessment and priority based interventions will help to prevent the complication at an early stage. CONCLUSION: Neurosurgery is a rewarding career choice, but there are many challenges and stressors that can lead to lower levels of satisfaction and dangerously increased level of burnout. Male sex could predispose to complication. The independent predictors of mortality in the present series were seizure, and reoperation for hematoma. Most of the problems arises at the initial 48 hours of post operative period. Prompt nursing assessment and priority based interventions was help to reduce the secondary problems of patients underwent craniotomy surgery. There is a significant association between GCS score admission and total number of elicited problem