Question

A 2¬Ω-year-old boy who has undergone surgery to revise a ventriculoperitoneal shunt is to be discharged. The nurse advises the parents to call the clinic if the child does what?

1) Appears drowsy after a nap and becomes irritable
2) Talks incessantly regardless of the presence of others
3) Becomes angry when frustrated and has a temper tantrum
4) Starts arguments with playmates, claiming that their toys are the child's

Answer 1

The parents should contact the clinic if their child appears excessively drowsy and irritable after a nap as it may indicate a problem with the shunt.

Step-by-step explanation:

When caring for a 2½-year-old boy who has undergone revision surgery for a ventriculoperitoneal shunt, the parents should be advised to call the clinic if their child appears drowsy after a nap and becomes irritable. This could indicate an issue with the shunt, such as underdraining or overdraining of cerebrospinal fluid (CSF), leading to increased intracranial pressure or the collapse of ventricles, both of which can be dangerous.

Implantation of a shunt is the typical treatment for hydrocephalus and involves careful monitoring of CSF drainage to avoid complications. Talking incessantly, becoming angry when frustrated, or starting arguments with playmates are generally normal behaviors for a child of this age and do not necessarily indicate a problem with the shunt. However, symptoms such as lethargy, irritability, light sensitivity, vomiting, or changes in behavior like excessive drowsiness after sleeping can be warning signs of a malfunctioning shunt.