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Summary

concept map describing hydrocephalus ...

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Case Study -E.J is a two-week-old male born at 36 weeks gestation and is brought to the E.R with s/s reported by parents as; not feeding well, vomiting after every breastfeeding, is very irritable and constantly crying. His mother is a 35 y.o female and this is her first child. She reported that she did have a difficult birth and experienced placental abruption. Assessment -Sun setting eyes -Bulging fontanels -Large head/circumference of 20 in. -High pitched cry -Excessive vomiting w/o being able to keep down milk -Diagnosed with hydrocephalus by Dr.

Patho -Excessive buildup of CSF due to obstruction in the ventricles of the brain such as a tumor or cyst(noncommunicating) -poor reabsorption or overproduction (communicating)

Development And Hydrocephalus

Clinical Manifestations -Abnormal rapid head growth -Bulging fontanels especially anterior fontanel -Dilated scalp veins -Separated sutures -Thinning of skull bones -Sunset eyes -Excessive vomiting -Poor feeding -Seizures -Irritability -High pitched cry -Soft spot feels stiff

Risk Factors -Premature birth -Complications during pregnancy -Fetal development problems -Tumors or cysts -Head injury -Genetics

Evaluation -The baby shows no signs of infection or s/s of increased ICP -Parents verbalize s/s to watch out for and know shunt care -Parents given adequate support through healthcare professionals and are given referrals to support groups -Family expresses they feel prepared to go home and watch for developmental milestones

Diagnosis Diagnosis is based on these common findings - Characteristic head anomalies - Diagnostic Test (MRI,CT,US, Spinal tap) -Risk for Infection: Risk factor: sequelae of invasive procedure (shun placement) -Interrupted Family processes r/t situational crisis

Plan -Provide support and education on diagnosis surgical procedures done -Prep child for surgical procedure -Provide support from social workers -Make sure parents know how to monitor for complications of shunt at home/post-op care -Monitor baby for appropriate growth development -Monitor for ICP and how to measure -Teach how to manage shunt as baby gets older

Interventions Risk for infection - Post op care will consist of frequent wound care and temp checks. - Report any s/s of infection immediately - Administer antibiotics as ordered - Teach parents s/s of infection to watch out for at home Interrupted Family process - Explain illness and procedure in terms they understand - Encourage them to express any fears or anxieties - Demonstrate shunt care and ask them to return demonstrate - Provide them with reference resources for s/s that should be reported - Discuss developmental and growth expectations

References Ackley, Betty J., et al. Nursing Diagnosis Handbook: an Evidence-Based Guide to Planning Care. Elsevier, 2020. P. 62 Han, Seunggu, and Yvette Brazier . “What Is Hydrocephalus or Water on the Brain?” Medicalnewstoday.com, Healthline Media UT LTS, 7 Dec. 2017, www.medicalnewstoday.com/articles/181727#prevention. “Hydrocephalus (for Parents) - Nemours KidsHealth.” Edited by Joseph H. Piatt Jr., KidsHealth, The Nemours Foundation, Sept. 2019, kidshealth.org/en/parents/hydrocephalus.html. “Hydrocephalus.” AANS, www.aans.org/Patients/Neurosurgical-Conditions-andTreatments/Hydrocephalus. “Myelomeningocele (Spina Bifida).” SSM Health, www.ssmhealth.com/cardinal-glennon/fetalcare-institute/head-spine/myelomeningocele. Perry, Shannon E., et al. Maternal Child Nursing Care, Sixth Edition. Elsevier, 2018. P. 13871390...