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Hydrocephalus
Hydrocephalus
Hydrocephalus
Hydrocephalus
Hydrocephalus
Hydrocephalus
Hydrocephalus
Hydrocephalus
Hydrocephalus
Hydrocephalus
Hydrocephalus
Hydrocephalus
Hydrocephalus
Hydrocephalus
Hydrocephalus
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Hydrocephalus

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  • 1. HYDROCEPHALUS Jed Ray G. Montayre, RN, MSN
  • 2. HYDROCEPHALUS <ul><li>characterized by an increased in the amount of CSF within the ventricle of the brain. </li></ul><ul><li>Types: </li></ul><ul><li>Communicating </li></ul><ul><li>Non-communicating </li></ul>
  • 3. Pathophysiology <ul><li>CAUSES: </li></ul><ul><li>> tumor or fibrosis > tumor at the choroid > Meningitis, severe </li></ul><ul><li>from infection or plexus CHF, subarachnoid </li></ul><ul><li>inflammation hemorrhage venous </li></ul><ul><li>> congenital malformation sinus thrombosis </li></ul><ul><li>> Spinal cord tumor </li></ul><ul><li>> GBS (producing a High CHON CSF) </li></ul><ul><li>  </li></ul><ul><li>pathways for the oversecretion of CSF </li></ul><ul><li>circulation of CSF is flow of CSF is plugged </li></ul><ul><li>blocked or narrowed or impeded by the </li></ul><ul><li>protein & cellular & </li></ul><ul><li>molecular debris </li></ul><ul><li>obstruction of CSF </li></ul><ul><li>Alteration in the absorption of CSF at the arachnoid granulation </li></ul><ul><li>Distention of the ventricles with the corresponding thinning of the white matter </li></ul>
  • 4. Signs and Symptoms ( Assessment – Nursing Process ) <ul><li>increase head circumference </li></ul><ul><li>cranial suture separation </li></ul><ul><li>downward rotation of eyes </li></ul><ul><li>Macewen’s Sign </li></ul><ul><li>Focal Neurologic Deficits </li></ul><ul><li>Increased ICP * </li></ul>
  • 5. Medical Management <ul><li>Diagnostic Tests: </li></ul><ul><li>1. Serial Transilluminations </li></ul><ul><li>2. CT Scan </li></ul><ul><li>  </li></ul><ul><li>Management: </li></ul><ul><li>Shunting (Ventriculoperitoneal & Ventriculoatrial) </li></ul><ul><li>> insertion of a flexible tube into the lateral ventricle of the brain (peritoneum or right atrium) </li></ul>
  • 6. NURSING RESPONSIBILITIES <ul><li>1. Pre-op care </li></ul><ul><li>2. Check neuro status </li></ul><ul><li>3. Post-op care </li></ul><ul><li>DO NOT flex neck on the side where the shunt is placed </li></ul><ul><li>Observe for signs of infection </li></ul><ul><li>Observe for signs of ICP </li></ul><ul><li>H-ead of bed (not more than 30 ) </li></ul><ul><li>E-valuate </li></ul><ul><li>A-irway </li></ul><ul><li>D-rainage </li></ul><ul><li>S-afety </li></ul><ul><li>4. Parental teaching </li></ul><ul><li>  </li></ul>
  • 7. Care of Client with Increased ICP <ul><li>-Maintain patent airway and adequate ventilation </li></ul><ul><li>- Prevent hypoxia and hypercabia </li></ul><ul><li>- Principles of suctioning </li></ul><ul><li>- Assist with mechanical hyperventilation </li></ul><ul><li>V/S and Neuro Check </li></ul><ul><li>HOB- 30 – 45 degrees </li></ul>
  • 8. Care of Client with Increased ICP <ul><li>-Prevent further Increased in ICP </li></ul><ul><li>-provide quite environment </li></ul><ul><li>-avoid straining, vomiting, excessive coughing </li></ul><ul><li>- avoid sharp and disturbing sensory stimulants ( light). </li></ul>
  • 9. Care of Client with Increased ICP <ul><li>Medication </li></ul><ul><li>Hyperosmotic agents- ( Mannitol)- decrease cerebral edema </li></ul><ul><li>Corticosteroid- ( Dexamethasone)- anti-inflammatory effect </li></ul><ul><li>Anticonvulsant </li></ul><ul><li>Analgesic ( Strong opiates are contraindicated) </li></ul>
  • 10. Care of Client with Increased ICP <ul><li>ICP monitoring </li></ul><ul><li>Barbiturate and Paralyzing agent Treatment </li></ul><ul><li>- Constant monitoring of ICP, Laboratory results </li></ul><ul><li>- Appropriate nursing care to patients with ventilator </li></ul>
  • 11. Nursing Care Plan <ul><li>Assessment- S/S and Laboratory Results </li></ul><ul><li>Nursing Diagnosis </li></ul><ul><li>Ineffective Airway and breathing pattern </li></ul><ul><li>Decrease Cerebral Perfusion </li></ul><ul><li>Impaired Sensory perception </li></ul><ul><li>Immobility </li></ul><ul><li>Risk for Injury </li></ul>
  • 12. Nursing Care Plan <ul><li>Nursing Goal </li></ul><ul><li>To prevent further brain injury </li></ul><ul><li>Sustain the body’s vital organ functioning </li></ul><ul><li>Provide comfort and avoid complications </li></ul>
  • 13. Nursing Care Plan <ul><li>Nursing Interventions </li></ul><ul><li>- Monitoring ABC’s and providing safe and comfort </li></ul><ul><li>Measures to prevent increase in ICP </li></ul><ul><li>Collaborative nursing responsibilities in assisting the doctor in special procedures </li></ul><ul><li>Parental teaching </li></ul>
  • 14. Nursing Care Plan <ul><li>Evaluation </li></ul><ul><li>Based on the results of the nursing measures </li></ul><ul><li>Outcomes in ICP monitoring </li></ul><ul><li>Manifestation of the clients </li></ul><ul><li>Parental understanding about the measures to avoid the increase of ICP. </li></ul>
  • 15. Thank You! Jed Ray G. Montayre, RN, MN-MSN

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