This document provides information about hydrocephalus, including:
1) Hydrocephalus is a build up of fluid in the skull that causes brain swelling and is caused by an imbalance in cerebrospinal fluid production and absorption.
2) It can be congenital or acquired and communicating or non-communicating. Common causes and types are described.
3) Treatment involves surgical management like shunt placement or endoscopic procedures to relieve pressure on the brain. Nursing management focuses on pre/post-op care, monitoring for complications, and teaching parents about home care.
Hydrocephalus is a disease that occurs in the human brain. When excess cerebrospinal fluid or CSF collects in the ventricles of the brain, the situation is called Hydrocephalus.
Hydrocephalus
introduction
Hydrocephalus, also known years ago as “water on the brain”, is a condition where the circulation system of the body’s cerebrospinal fluid (CSF) is not functioning properly. The CSF accumulates in the brain and causes intracranial pressure. A shunt is usually placed to equalize the flow of CSF, which requires surgery. The diagnosis and surgery can be very frightening for the parents as well as the child
definition
Hydrocephalus is a condition characterized by an excess of cerebrospinal fluid (CSF) within the ventricular and subarachnoid spaces of the cranial cavity
INCIDENCE
It is found in 1-3 of every 1000 born children in world wide
Classification
Non communicating. In the non communicating type of congenital hydrocephalus, an obstruction occurs in the free circulation of CSF.
Communicating. In the communicating type of hydrocephalus, no obstruction of the free flow of the CSF exists between the ventricles and the spinal theca; rather, the condition is caused by defective absorption of CSF, thus causing increased pressure on the brain or spinal cord.
CAUSES
Obstruction. The most common problem is a partial obstruction of the normal flow of CSF, either from one ventricle to another or from the ventricles to other spaces around the brain.
Poor absorption. Less common is a problem with the mechanisms that enable the blood vessels to absorb CSF; this is often related to inflammation of brain tissues from disease or injury.
Overproduction. Rarely, the mechanisms for producing CSF create more than normal and more quickly than it can be absorbed.
PATHOPHYSIOLOGY
CLINICAL MANIFESTATION
Poor feeding. The infant with hydrocephalus has trouble in feeding due to the difficulty of his condition.
Large head. 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.
High-pitched cry. The intracranial pressure may increase and the infant’s cry could become high-pitched.
Irritability. Irritability is also caused by an increase in the intracranial pressure.
Projectile vomiting. An increase in the intracranial pressure can cause projectile vomiting
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conclusions
Hydrocephalus is a disease that occurs in the human brain. When excess cerebrospinal fluid or CSF collects in the ventricles of the brain, the situation is called Hydrocephalus.
Hydrocephalus
introduction
Hydrocephalus, also known years ago as “water on the brain”, is a condition where the circulation system of the body’s cerebrospinal fluid (CSF) is not functioning properly. The CSF accumulates in the brain and causes intracranial pressure. A shunt is usually placed to equalize the flow of CSF, which requires surgery. The diagnosis and surgery can be very frightening for the parents as well as the child
definition
Hydrocephalus is a condition characterized by an excess of cerebrospinal fluid (CSF) within the ventricular and subarachnoid spaces of the cranial cavity
INCIDENCE
It is found in 1-3 of every 1000 born children in world wide
Classification
Non communicating. In the non communicating type of congenital hydrocephalus, an obstruction occurs in the free circulation of CSF.
Communicating. In the communicating type of hydrocephalus, no obstruction of the free flow of the CSF exists between the ventricles and the spinal theca; rather, the condition is caused by defective absorption of CSF, thus causing increased pressure on the brain or spinal cord.
CAUSES
Obstruction. The most common problem is a partial obstruction of the normal flow of CSF, either from one ventricle to another or from the ventricles to other spaces around the brain.
Poor absorption. Less common is a problem with the mechanisms that enable the blood vessels to absorb CSF; this is often related to inflammation of brain tissues from disease or injury.
Overproduction. Rarely, the mechanisms for producing CSF create more than normal and more quickly than it can be absorbed.
PATHOPHYSIOLOGY
CLINICAL MANIFESTATION
Poor feeding. The infant with hydrocephalus has trouble in feeding due to the difficulty of his condition.
Large head. 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.
High-pitched cry. The intracranial pressure may increase and the infant’s cry could become high-pitched.
Irritability. Irritability is also caused by an increase in the intracranial pressure.
Projectile vomiting. An increase in the intracranial pressure can cause projectile vomiting
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conclusions
It's about HYDROCEPHALUS
TO EXPLAIN ANATOMY OF HUMAN BRAIN
TO INTRODUCE HYDROCEPHALUS
TO DEFINE HYDROCEPHALUS
TO EXPLAIN INCIDENCE OF HYDROCEPHALUS
TO EXPLAIN ETIOLOGY OF HYDROCEPHALUS
TO EXPLAIN PATHOPHYSIOLOGY OF HYDROCEPHALUS
TO EXPLAIN CLINICAL MANIFESTATION OF HYDROCEPHALUS
TO ENLIST DIAGNOSIS & DIAGNOSTIC EVALUATION FOR HYDROCEPHALUS
TO DESCRIBE MANAGEMENT OF HYDROCEPHALUS
TO EXPLAIN COMPLICATION & PROGNOSIS OF HYDROCEPHALUS
The anatomy of the ventricular system, the physiology in production of CSF, the pathogenesis, and the different paediatric and adult forms of hydrocephalus.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
2. Term derived from two Greek
words-
“hydro” means water and
“cephalus” means head.
This condition is sometimes known as “water
in the brain”.
3.
Hydrocephalus is a condition caused
by an imbalance in the production
and absorption of CSF in the
ventricular system.
When production exceeds
absorption, CSF accumulates,
usually under pressure, producing
dilation of the ventricles.
Hydrocephalus is a build up of fluid inside
the skull, leading to brain swelling.
4.
5. Incidence of primary hydrocephalus without
spina bifida is approximately 1 in 2500 live
births, making it one of the most common
developmental disabilities, more common
than Down syndrome or deafness. It is the
leading cause of brain surgery for children.
In the past 25 years, death rates associated
with hydrocephalus have decreased from 54%
to 5% and the occurrence of intellectual
disability has decreased from 62% to 30%.
6.
7.
8. 1) CONGENITAL HYDROCEPHALUS
I. Intrauterine infections: Rubella,
Cytomegalovirus, Toxoplasmosis.
II. Trauma: Subarachnoid, Intracranial,
Intraventricular haemorrhages.
III.Congenital malformations:
Dandy-walker syndrome: here posterior fossa
cyst continuous with 4th ventricle.
9. Aqueduct stenosis: it accounts for 33% of
hydrocephalus cases. Stenosis of aqueduct of
sylvius causes dilation of lateral and 3rd
ventricles. In 2% of cases this could be
familial with X linked recessive inheritance.
Arnold-Chiari syndrome- Portions of
cerebellum & brainstem herniating into
cervical spinal canal, blocking the flow of
CSF to the posterior fossa.
11. CSF is secreted at the choroid plexus within the ventricles by ultra
filtration & active secretion.
Lateral ventricles
FORAMEN OF MONRO
3rd ventricle
AQUEDUCT OF SYLVIUS
4th ventricle
CONTD…
12. Via lateral foramen of luschka & foramen
of magendie
Cistern magna
Cerebral & cerebellar subarachnoid
spaces
17.
A large portion is absorbed through the
arachnoid villi, but the sinuses, veins, brain
substance & dura also participate in
absorption.
About 20ml of CSF is secreted in an hour.
• The total of CSF approximates 50ml in
an infant and 150ml in adults.
18. There are two types of hydrocephalus: -
1) Noncommunicating(intraventricular or
obstructive) hydrocephalus-In this there is
blockage between the ventricular &
subarachnoid systems, resulting in an
interference with circulation of CSF & lack of
access to the subaracnoid spaces. In this
fluid distends the ventricles. There is a
gradual thinning of the brain substance,
which is compressed between the distended
ventricles & the expanding skull.
19.
Noncommunicating hydrocephalus
may be due to stenosis of the
aqueduct of sylivus, either a
congenital defect or acquired.
Obstructive hydrocephalus may result
postnatally from brain tumors that put
pressure on or extend into the
ventricles or circulation pathways.
20.
21. 2) Communicating
(extraventricular)hydrocephalus- In this
there is normal communication between the
ventricles & the spinal subarachnoid space.
There is an interference with the absorption
of CSF caused by an occlusion of the
subarachnoid cisterns around the brain stem.
The fluid that is not absorbed in the
subarachnoid space accumulates,
compressing the brain & distending the
cranial cavity.
22. Communicating hydrocephalus may be due to
subarachnoid hemorrhage or meningitis,
toxoplasmosis or cytomegalovirus infection,
in which there is an obliteration of the
subarachnoid spaces by fibrous tissue
reaction, or to diseases of connective tissue.
23. IN INFANTS-
Head grows at abnormal rate.
Anterior fontanel is tense, often bulging, & non
pulsatile.
Scalp veins are dilated & markedly so when
infant cries.
Macewen’s sign- with increase in intracranial
volume, the bones of the skull become thin &
the sutures become palpably separated to
produce the cracked pot sound on the percussion
of the skull.
Frontal bossing with depressed eyes.
Setting-sun sign- eyes rotated downward, in
which sclera may be visible above iris.
24.
25. Feeds poorly
•Pupils are sluggish, with unequal response to light
• Changes in level of consciousness.
• Opisthotonus position & lower extremity spasticity.
• Cries when picked up & quiets when allowed to lie still.
• If hydrocephalus is allowed to progress- there
• will be disruption in the lower brainstem
• function as manifested by difficulty in feeding &
• a shrill, brief, high-pitched cry. Eventually the
• skull becomes enlarged, & the cortex is destroyed.
26.
If the condition progress rapidly, the
infant may display emesis,
somnolence, seizures &
cardiopulmonary distress.
IN CHILDHOOD-
Headache on awakening with improvement
following emesis or upright posture.
Papilledema, strabismus.
Irritable & lethargic.
Apathetic, confused & often incoherent.
Bulging occiput, nystagmus, ataxia & cranial
nerve palsies.
27. Routine daily head (occipitofrontal)
circumference measurements.
Echoencephalography.
A head CT scan is one of the best tests for
identifying hydrocephalus.
Arteriography.
Brain scan using radioisotopes
Cranial ultrasound (an ultrasound of the brain)
Lumbar puncture and examination of the
cerebrospinal fluid (rarely done).
Skull x-rays.
28. The treatment of hydrocephalus is
directed toward –
Relief of the
hydrocephalus,
Treatment of
complications,
Management of problems related to the
effect of the disorder on psychomotor
development. The treatment is, with few
exceptions, surgical.
30.
This can be tried in mild
cases of hydrocephalus.
Acetozolamide: dose of
50mg/kg/day dimnishes CSF
production.
Oral glycerol has also been used for the
similar purpose.
31. It may consist of
The removal of the obstruction (tumor,
hemorrhage or cyst) to the flow of CSF.
Reduction in the amount of CSF produced
through destruction of a portion of the choroid
plexus or a third or fourth ventriculostomy.
Shunting of CSF from the ventricle to another
site in the normal circulatory passageway of this
fluid.
Shunting of CSF from the ventricle to an area
outside the CNS, an extracranial body
compartment.
32. Shunting is the most common procedure to be
done in the surgical management of
hydrocephalus.
Most shunt systems consist of a ventricular
catheter, a flush pump, a unidirectional flow
valve & a distal catheter. All are radiopaque
for easy visualization after placement & all
are tested before insertion.
34. Ventriculoperitonial(VP) shunt- This is the
preferred procedure especially in neonates &
young infants. There is greater allowance for
excess tubing, which minimizes the number
of revisions needed as the child grows. In this
ventricular catheter is inserted into the
anterior portion of a lateral ventricle through
a burr hole in the skull.
35. An incision is made in abdomen & through
the rectus muscle into the peritoneum. The
proximal end of the catheter is slipped
beneath the skin of anterior abdominal &
chest wall to the neck. The ventricular
catheter with attached valve is then sutured
to the peritoneal catheter. The CSF is
absorbed by tissues in the abdominal cavity.
38. Ventriculoatrial(VA) shunt- It is reserved for
older children who have attained most of
their somatic growth & children with
abdominal pathology. It requires repeated
lengthening as child grows. A silicon catheter
is inserted in lateral ventricle & down
through the internal jugular vein into left
atrium of the heart.
39.
The CSF drains into circulating blood.
This type of shunt may become easily
obstructed or infected. If an infection
occurs, bacterial endocarditis,
ventriculitis & bacteremia may result.
40.
Ventriculopleural shunts- these shunts are
sometimes used in children over 5 years of
age. This type of shunt drains fluid from the
lateral ventricle to the pleural cavity.
• Drainage of the CSF may cause hydrothorax, necessitating either
removal of the shunt or a thoracentesis. The nurse must observe these
children carefully for respiratory difficulties.
41. Endoscopic third ventriculostomy- It is a
procedure that has potential for greater
independence from VP or VA shunting in
children with noncommunicating
hydrocephalus. In this procedure a small
opening is made in the floor of the 3rd
ventricle, allowing CSF to flow freely through
previously blocked ventricle, thus bypassing
the aqueduct of sylvius.
42. Reports of the success of endoscopic third
ventriculostomy in children; however, as
surgical techniques & advances continue, it
is expected that neonates & small children
will be successfully treated with this
procedure rather than conventional shunting.
43.
44.
The major complications of
shunts are
infection & malfunction.
All shunts are subjected to mechanical
difficulties, such as kinking, plugging, or
separation & migration of tubing.
45. 1) Malfunction is most often caused by
mechanical obstruction either within the
ventricles from articulate matter (tissue or
exudates) or at the distal end from
thrombosis or displacement as a result of
growth. The child with a shunt obstruction
often presents as an emergency with clinical
manifestations of increased ICP, frequently
accompanied by worsening neurologic status.
46. 2) Shunt infection is also a serious
complication of shunts. It can occur at any
time, but the period of greatest risk is 1 to 2
months following placement. The infection
may be a result of intercurrent infections at
the time of shunt replacement. Infections
include sepsis, bacterial endocarditis, wound
infection, shunt nephritis, meningitis.
47. 3)Another serious shunt-related complication
is subdural hematoma caused by rapid
reduction of ICP & size.
4)Other complications that may include
peritonitis, abdominal abscesses, perforation
of abdominal organs by catheter or trochar
(at the time of insertion), fistulas, hernias.
48. NURSING MANAGEMENT
A)Teach the family about the management required
for the disorder.
a)Treatment is surgical by direct removal of an
obstruction and insertion of shunt to provide primary
drainage of the CSF to an extracranial compartment,
usually peritoneum (ventriculoperitoneal shunt).
1.The major complications of shunts are infections and
malfunction.
2.Other complications include subdural hematoma
caused by a too rapid reduction of CSF, peritonitis,
abdominal abscess, perforation of organs, fistulas,
hernias and ileus.
b. A third ventriculostomy is a new nonshunting
procedure used to treat children with hydrocephalus.
49. NURSING MANAGEMENT contd…
B) Provide preoperative nursing care
a.Assess head circumference, fontanelles,
cranial sutures, and LOC; check also for
irritability, altered feeding habits and a high-
pitched cry.
b.Firmly support the head and neck when
holding the child.
c.Provide skin care for the head to prevent
breakdown.
d.Give small, frequent feedings to decrease
the risk of vomiting.
e. Encourage parental-newborn bonding.
50. NURSING MANAGEMENT contd…
C) Provide Postoperative nursing care
a.Assess for signs of increased ICP and check the
following; head circumference (daily), anterior
fontanels for size and fullness and behaviour.
b.Administer prescribed medications which may
include antibiotics to prevent infection and
analgesics for pain.
c.If there is increased ICP elevate the head of the bed
or allow the child to sit up to enhance gravity flow
through shunt.
d. Observe the child for abdominal distension.
e. Maintain intake-output chart.
51. NURSING MANAGEMENT contd…
f. Provide shunt care
1.Monitor for shunt infection and malfunction which
may be characterized by rapid onset of vomiting,
severe headache, irritability, lethargy, fever, redness
along the shunt tract, and fluid around the shunt
valve.
2.Prevent infection (usually from Staphylococcus
epidermis or Staphylococcus aureus)
3.Monitor for shunt overdrainage (headache, dizziness
and nausea). Overdrainage may lead to slit ventricle
syndrome whereby the ventricle become accustomed
to a very small or slitlike configuration, limiting the
buffering ability to increased ICP variations
52. NURSING MANAGEMENT contd…
D) Teach home care
a.Encourage the child to participate in age-
appropriate activities as tolerated.
Encourage the parents to provide as normal
lifestyle as possible.
b.Explain how to recognize signs and
symptoms of increased ICP. Subtle signs
include changes in school performance,
intermittent headache, and mild behavior
changes
c.Frequent developmental screenings & follow
ups.
53. 1) NURSING DIAGNOSIS- Ineffective
cerebral tissue perfusion related to
increased ICP.
Expected outcome- There will be effective
cerebral tissue perfusion.
Interventions:
Give proper positioning to the baby. Keep
the head of the baby in neutral (midline)
position to promote venous drainage.
Avoid extreme rotation & flexion of the neck
as these can cause compression & distortion
of jugular veins which will further increase
the ICP.
54.
Elevate the head at 30 to 45 degree to
aid in venous drainage.
Extreme hip flexion is also avoided as
this position causes increase in intra-
abdominal & intra-thoracic pressures,
which can produce a rise in ICP.
While turning hold the head of baby to avoid
any stimuli.
Check for abdominal distension it also results
in the rise of ICP.
55. 2) NURSING DIAGNOSIS- Imbalanced
nutrition, less than body requirement
related to reduced oral intake &
vomiting. Expected outcome- Nutritional status of the
baby will be maintained.
Interventions:
Assess the nutritional status of the baby.
Weigh the baby daily & record.
56.
Maintain intake-output chart of the
baby. Provide exclusive breast
feeding to the neonates & infants up
to 6 months of age. For older children, offer small frequent
feedings of light food.
57. 3) NURSING DIAGNOSIS- Risk for
impaired skin integrity related to
enlarged head.
Expected outcome- Skin integrity will be
maintained.
Interventions:
Assess the skin integrity of the baby.
Prevent the pressure on the enlarged head.
Provide firm-soft pillow under child’s head.
Keep the area clean & dry.
Good skin care & range of motion exercise
are also essential to prevent skin breakdown.
58. 4) NURSING DIAGNOSIS- Risk for infection related
to introduction of infecting organism through
shunt.
Expected outcome- There will be no sign &
symptom of infection.
Interventions:
Check & record the vital signs of the baby.
Use aseptic technique while doing any procedure
on the baby.
Wash the hands properly before touching the
baby.
Maintain the general cleanliness of the area &
baby.
Administer the antibiotics as prescribed.
59. 5) NURSING DIAGNOSIS- Ineffective family coping
related to life threatening problem of infant.
Expected outcome- Family will be able to cope
up with the problem.
Interventions:
Tell the family about the disease condition
(causes, treatment, prognosis).
Educate them about the care of baby like
maintaining the cleanliness, proper diet, skin
care, positioning of the baby (initially flat to
prevent the excessive CSF drainage then gradual
elevation of head of child’s bed to 30 to 45
degree).
60.
Educate the family about the shunt
& its purpose.
Tell them about the assessment for
excessive drainage of CSF (sunken
fontanel, agitation, decrease level of
consciousness). Encourage them for treatment compliance &
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