T3 - Hydrocephalus (Josh) Flashcards
Hydrocephalus is an —
abnormal accumulation of fluid
What is the primary cause of Hydrocephalus?
blockage/obstruction somewhere along the circulatory pathway of CSF
Primary cause of Hydrocephalus?
Arnold Chiari Syndrome
S/S of Hydrocephalus?
Sunset Sign (depression of eyes)
inc. head circumference
high pitched cry
poor feeding if ICP is too high
What is the biggest complication of surgery for shunts?
infection
What to look for in eyes with hydrocephalus?
Sunset Eyes (depressed eyes)
Types of obstructions that cause Hydrocephalus?
Infection
Hemmorrhage
Tumor
Myleomeningocele
S/S of Hydrocephalus:
bulging fontanels
thinning skull bones
dilation of scalp veins
sunset eyes
irritability
shrill, high pitched cry
opisthotonus
Which meds can help decrease production of CSF until surgery for hydrocephalus can be done?
Furosemide
Asetazolamide
The best and most effective treatment for hydrocephalus is –
Shunts
- 1/8 in diamter tube
VP Shunt drains into –
VA Shunt drains into –
peritoneum
right atrium of heart
When would a VA shunt be preferred?
When abdominal surgery has been done or they have GI probs
When is shunt commonly placed?
3-4 mths of age
Pre-op care for Shunt surgery
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
Signs of ICP:
Bulging fontanel
enlarged head circumference
BEHAVIOR CHANGES
IRRITABILITY
Why is head of bed initially flat after Shunt surgery?
so drain is not too fast
Parental support and discharge teaching for Shunt surgery.
- avoid contact sports
- protective helmets when riding bikes
Post op for Shunt Surgery
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
Shunt infection is primarily from –
client’s OWN organisms (not exposure to ill people)
Children w/ VP shunts are more prone to –
Children w/ VA shunts are more prone to –
abdominal infection
generalized infection
Shunt infection frequently results in – and may produce – or – along the shunt tract
fever
reddening
swelling
