CRNE Exam Prep

Category - Changes in Health

A nurse is caring for Elaine, a 5-year-old child who was admitted due to a suspected case of brain tumor. Diagnostic tests reveal that the child has a brain tumor involving the cerebellum. A surgery is ordered. During the pre-operative period, which of the following is the most important nursing intervention for the client?
  1. Initiate seizure precautions.
  2. Monitor the child’s temperature every 2 hours.
  3. Measure the child’s circumference every morning.
  4. Initiate fall precautions
Explanation
Answer: D - The most important nursing intervention is to initiate fall precautions. This intervention aims to protect the child from falls. The cerebellum controls motor movement coordination, balance and equilibrium. A tumor in the cerebellum can lead to ataxia, a condition that increases the child’s risk to falls. Seizures are expected during the late stage of brain tumor. The child’s fontanels have closed by the age of 5 years. A tumor in the cerebellum does not affect body temperature.
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