Brain tumors are the second most common malignancy to occur during childhood and the posterior fossa is the most common region of the brain affected, Diagnosis and treatment are complex and challenging. Once a child suffering from a posterior fossa tumor is identified, a multidisciplinary team must be assembled to provide comprehensive care through all phases of treatment. The nursing staff is vital to this team because they are often the individuals who coordinate services involved in the care of the child with a posterior fossa tumor. This case study illustrates the phases of diagnosis and treatment of a child with a medulloblastoma and highlights critical care nursing challenges. Following the case study presentation, a summary describes posterior fossa tumors including epidemiology, pathophysiology, clinical manifestations, critical care nursing, complications, and outcome. The case study is integrated throughout this review to highlight key issues for critical care nurses to explore
Severe childhood asthma is a serious, life-threatening disease that presents a challenge for patients, families, and caregivers. Despite evolving medical and pharmacologic therapies, the Incidence and severity of asthma are increasing. Vasoactive substances are released in response to environmental and intrinsic triggers and result in bronchospasm, bronchial mucosal edema, and mucus plugging of the airways. Early recognition of symptoms and prompt, aggressive treatment, including oxygen, beta agonists, corticosteroids, and anticholinergic agents, are essential in halting the progression of asthma symptoms, In the most severe cases, intubation, mechanical ventilation, and treatment with anesthetic agents may be needed to avoid significant morbidity and mortality. This article reviews epidemiology, pathophyslology, and acute care of the child experiencing an acute asthma exacerbation.