T3 - Hydrocephalus (Josh)

Question 1

Hydrocephalus is an —

Answer 1

abnormal accumulation of fluid

Question 2

What is the primary cause of Hydrocephalus?

Answer 2

blockage/obstruction somewhere along the circulatory pathway of CSF

Question 3

Primary cause of Hydrocephalus?

Answer 3

Arnold Chiari Syndrome

Question 4

S/S of Hydrocephalus?

Answer 4

Sunset Sign (depression of eyes)

inc. head circumference

high pitched cry

poor feeding if ICP is too high

Question 5

What is the biggest complication of surgery for shunts?

Answer 5

infection

Question 6

What to look for in eyes with hydrocephalus?

Answer 6

Sunset Eyes (depressed eyes)

Question 7

Types of obstructions that cause Hydrocephalus?

Answer 7

Infection

Hemmorrhage

Tumor

Myleomeningocele

Question 8

S/S of Hydrocephalus:

Answer 8

bulging fontanels

thinning skull bones

dilation of scalp veins

sunset eyes

irritability

shrill, high pitched cry

opisthotonus

Question 9

Which meds can help decrease production of CSF until surgery for hydrocephalus can be done?

Answer 9

Furosemide

Asetazolamide

Question 10

The best and most effective treatment for hydrocephalus is –

Answer 10

Shunts

• 1/8 in diamter tube

Question 11

VP Shunt drains into –

VA Shunt drains into –

Answer 11

peritoneum

right atrium of heart

Question 12

When would a VA shunt be preferred?

Answer 12

When abdominal surgery has been done or they have GI probs

Question 13

When is shunt commonly placed?

Answer 13

3-4 mths of age

Question 14

Pre-op care for Shunt surgery

Answer 14

Observe for signs of ICP

Care of the externalized shunt if indicated

Support large head

proper skin care

informed consent

seizure precautions

maintain adequate nutrition

Question 15

Signs of ICP:

Answer 15

Bulging fontanel

enlarged head circumference

BEHAVIOR CHANGES

IRRITABILITY

Question 16

Why is head of bed initially flat after Shunt surgery?

Answer 16

so drain is not too fast

Question 17

Parental support and discharge teaching for Shunt surgery.

Answer 17

• avoid contact sports

- protective helmets when riding bikes

Question 18

Post op for Shunt Surgery

Answer 18

Position on unaffected side

Bed flat (so drainage won’t be too fast)

Avoid sedatives

Observe for ICP

Assess for signs of infection

neuro assessment

vital signs

care of post-op site

pain control

Question 19

Shunt infection is primarily from –

Answer 19

client’s OWN organisms (not exposure to ill people)

Question 20

Children w/ VP shunts are more prone to –

Children w/ VA shunts are more prone to –

Answer 20

abdominal infection

generalized infection

Question 21

Shunt infection frequently results in – and may produce – or – along the shunt tract

Answer 21

fever

reddening

swelling