Shunts

  1. General information
    1. Insertion of a flexible tube into the lateral ventricle of the brain
    2. Catheter is then threaded under the skin and the distal end positioned in the peritoneum (most common type) or the right atrium; a subcutaneous pump may be attached to ensure patency
    3. Shunt drains excess CSF from the lateral ventricles of the brain in communicating or noncommunicating hydrocephalus; fluid is then absorbed by the peritoneum or enters the general circulation via the right atrium
  2. Nursing interventions
    1. Provide routine pre-op care with special attention to monitoring neurologic status.
    2. Provide post-op care.
      1. Maintain patency of the shunt.
        1. position child off the operative site.
        2. pump the shunt as ordered.
        3. observe for signs of infection of the incision.
        4. observe for signs of increased ICP.
        5. position the child with head slightly elevated or as ordered.
    3. Instruct parents regarding
      1. Wound care, positioning of infant, and how to pump the shunt
      2. Signs of infection
      3. Signs of increased ICP
      4. Need for repeated shunt revisions as child grows or if shunt becomes blocked or infected
      5. Expected level of developmental functioning
      6. Availability of support groups and community agencies

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