Provide hygienic careEducate family and find ways for them to participate in care 14. What is hydrocephalus? When CSF abnormally collects in the brain and the ventricles become swollen15. What are the two types of hydrocephalus? Congenital- born with it, large head, separated sutures, bulging fontanelsAcquired- can be communicating: flow between ventricles is not blocked but is blocked after leaving the ventricles, or non-communicating: CSF is blocked somewhere within the ventricles 16. How do you diagnose hydrocephalus? With CT or MRI (with sedation!) to see the obstruction or increased ventricle size17. How is hydrocephalus treated? Surgically with a shunt placed to divert CSF flow from the brain to another part of the body- can go into the abdomen, pleural space or aorta18. What does the pressure gradient in the shunt do? Regulates the flow of CSF19. How do you care for hydrocephalus patients post-op? Keep flat (HOB 15-20) to decrease ICPPosition on unaffected sideAssess frequently with Q1hr neuro checksEducate parents about S&S of infection, ICP and obstruction 20. What are the two types of neural tube defects? Spina bifida and anencephaly 21. How do neural tube defects occur? Due to a deficiency in folic acid during prenatal development22. What is anencephaly? It is when the brain does not develop during fetal development (can be detected between 16-18 weeks of pregnancy)23. What is spina bifida? It is when the spinal column does not completely close24. Three types of spina bifida: Spina bifida cystica- spinal cord and nerves are visible on the outside of the body, causes partial to complete paralysis below the siteMeningocele- a sac of CSF covered by skin that doesn’t always create a disabilitySpina bifida occulta- a section of malformed vertebra, but cord and nerves are intact. The defect is often found accidentally. This is called the tethered cord syndrome, and will need a tethered cord surgery to be fixed.25. How do you diagnose spina bifida? Visualization of sac, MRI, ultrasound, CT, myelography (Fluoroscopy injected into spine), transillumination26. Interventions for spina bifida?Prevent infection/sac rupture by not using diapers, prone position, use saline soaked gauze to keep moistNeurogenic bladder
Neuro dysfunctions- hydrocephalus: assess for increased ICP, assess fontanelles+ head circumferenceLatex free environment (commonly have a latex allergy)Family education27. What is Chiari malformation? A structural defect where the bony space in the lower skull is smaller than normal and increases pressure on the cerebellum to block flow of CSF.