CONGENITAL DISORDERS (HYDROCEPHALUS) (PATHOPHYSIOLOGY (In hydrocephalus,…
CONGENITAL DISORDERS (HYDROCEPHALUS)
In hydrocephalus, the CSF accumulates within the cranial cavity ventricles of the brain,causing an increase in pressure in the cranial cavity.
The infant with hydrocephalus has trouble in feeding due to the difficulty of his condition.
An excessively large head at birth is suggestive of hydrocephalus.
Bulging of the anterior fontanelles.
The anterior fontanelle becomes tense and bulging, the skull enlarges in all diameters, and the scalp becomes shiny and its veins dilate.
Setting sun sign
. If pressure continues to increase without intervention, the eyes appear to be pushed downward slightly with the sclera visible above the iris- the so-called setting sun sign.
The intracranial pressure may increase and the infant’s cry could become high-pitched.
Irritability is also caused by an increase in the intracranial pressure.
. An increase in the intracranial pressure can cause projectile vomiting.
NURSING CARE PLAN
At least every 2 to 4 hours, monitor the newborn’s level of consciousness.
Promoting skin integrity.
After a shunting procedure, keep the newborn’s head turned away from the operative site until the physician allows a change in position; reposition the newborn at least every 2 hours.
Closely observe for and promptly report any signs of infection; perform wound care thoroughly
Promoting growth and development.
The newborn needs social interaction and needs to be talked to and played with.
Reducing family anxiety.
Explain to the family the condition and the anatomy of the surgical procedure in terms they can understand.
Providing family teaching.
Demonstrate care of the shunt to the family caregivers and have them perform a return demonstration.
Surgical treatment is the preferred therapeutic option in patients with hydrocephalus.
Ventriculoperitoneal (VP) shunt.
A ventriculoperitoneal (VP) shunt is a medical device that relieves pressure on the brain caused by fluid accumulation.
Only used for communicating hydrocephalus, CSF fistula, or pseudotumor cerebri).
Torkildsen shunt (rarely).
Effective only in acquired obstructive hydrocephalus.
Ventriculopleural shunt (second-line therapy).
Used if other shunt types contraindicated.
Ventriculoatrial (VA) shunt
. Ventriculoatrial shunt placement enables cerebrospinal fluid (CSF) to flow from the cerebral ventricular system to the atrium of the heart.