Hydrocephalus

Question 1

Pathophysiology

Answer 1

1. Results from an imbalance in the production and absorption of CSF
2. CSF accumulates within the ventricular system and causes the ventricles to enlarge and increase in ICP

Question 2

Signs and Symptoms

Answer 2

1. Irritability
2. Lethargy
3. Poor Feeding
4. Vomiting
5. Complaints of headaches in older children
6. Altered, diminished or changes in LOC

Question 3

Complications

Answer 3

1. Growth and Developmental Delays

Question 4

Nursing Assessment: Physical Examination

Answer 4

1. In infants, a rapid increase in head circumference
2. In older children, loss of development and changes in personality
3. Brisk reflexes and spasticity of the lower extremities

Question 5

Laboratory and Diagnostics

Answer 5

1. Skull X-ray
2. CT
3. MRI

Question 6

Nursing Management: Preventing and Recognizing Shunt Infection and Malfunction

Answer 6

MAJOR COMPLICATIONS: Infection, malfunction, obstruction

1. Shunt Infection includes:
   > elevated vital signs
   > poor feeding
   > vomiting
   > decreased responsiveness
   > seizure activity
   > local inflammation along the shunt track
2. Shunt Malformation includes:
   > vomiting
   > drowsiness
   > headache
3. Infection is treated with antibiotics and if the infection is persistent, the shunt will be removed and an external ventricular drainage system will be put in until CSF is sterile
4. Malfunction occurs due to kinking, clogging, or separation of the tubing
   > Blockage is the most common reported complication
5. A shunt that has been placed within the past year is at higher risk for malfunction