What is a priority of care when a child has an external ...

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What is a priority of care when a child has an external ventricular drain (EVD)?
 
  a. Irrigation of drain to maintain flow
  b. As-needed dressing changes if dressing becomes wet
  c. Frequent assessment of amount and color of drainage
  d. Maintaining the EVD below the level of the child's head

Question 2

A child is admitted for revision of a ventriculoperitonea l shunt for noncommunicating hydrocephalus. What is a common reason for elective revision of this shunt?
 
  a. Meningitis
  b. Gastrointestinal upset
  c. Hydrocephalus resolution
  d. Growth of the child since the initial shunting

[braelync]

Answer to Question 1

ANS: C
The EVD is inserted into the child's ventricle. Frequent assessment is necessary to determine amount of drainage and whether an infection is present. The EVD is a closed system and is not opened for irrigation. Antibiotics may be administered through the drain, but this is usually done by the neuropractitioner. The dressing is not changed. If it becomes wet, then the practitioner should be notified that cerebrospinal fluid (CSF) may be leaking. Unless ordered, maintaining the EVD below the level of the child's head position will create too much pressure and potentially drain too much CSF.

Answer to Question 2

ANS: D
An elective revision of a ventriculoperitonea l shunt would most likely be done to accommodate the child's growth. Meningitis would require an emergent replacement or revision of the shunt. Gastrointestinal upset alone would not indicate the need for shunt revision. Noncommunicating hydrocephalus will not resolve without surgical intervention.

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TYSM

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