1. Ventriculostomy N451 Clinical Presentation
Megan Bess
Michael Coughlin
Melissa Johnston
Lakesa Williams

2. Objectives · Identify an external ventricular drain
Explain the operation of an external ventricular drain
Describe the indications for a ventriculostomy
· Identify three of six nursing interventions for the patient with increased intracranial pressure

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4. Indications Obstructive Hydrocephalus is the most common cause
Inflammation (Trauma or infection)
Neoplastic obstruction (Tumors)
Aqueduct Stenosis
Connects the 3rd ventricle and the 4th
Stenosis does not allow for fluid to flow causing hydrocephalus.
median aperture blockage
Lateral aperture blockage

5. Indications Shunt Malfunction Myelomeningocele
Spine does not fuse together to cover the spinal cord
Cerebellum falls low causing block in circulation and CSF produced in the brain to over accumulate.

6. Nursing Interventions
Nurses are the first to see changes in the Intensive care patient!
WHY?

7. Nursing Interventions
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8. Nursing Interventions
Maintain core body temperature within normal range using antipyretics or hypothermia blankets as ordered.
Maintain head of bed( HOB) at 30 degrees unless contraindicated
Maintain head and neck in neutral alignment. Avoid neck flaexion and rotation.

9. Nursing Interventions
Avoid Valsalva maneuver with position changes
Reorient the patient to the environment as needed
Limit direct care activities

10. Research
Single Versus Bilateral External Ventricular Drainage for Intraventricular Fibrinolysis using Urokinase in Severe Ventricular Hemorrhage
Nursing Interventions for Critically Ill Traumatic Brain Injury Patients

11. Post-est Identify the following device: Internal Ventricular Drain
External Ventricular Drain
Bilateral Ventricular Drain
None of the Above

12. Post-test
When operating a external ventricular drain a nurse will...SELECT ALL THAT APPLY
Maintain the drain level to the tragus
Read drainage amount at the bottom of the meniscus and note color
Maintain the drain level to the pinna
Zero the drain prior to first use and every 4 hrs
Flex the patient’s neck for better drainage

13. Post-test The client head of bed (HOB) should be kept at what level?
A degrees
B degrees unless contraindicated
C degrees
D. 25 degrees unless contraindicated

14. Post-test
All of the following nursing care activities should be avoided in a patient with ICP except?
A. Routine linen change
B. Oral care
C. Routine Bathing
D. Hourly position changes

15. Post-test
The most important goal for the nurse taking care of patient with increased ICP is to decrease ICP?
A. True
B. False

16. Post-test
Which of the following signs in a patient are an early indication of possible hydrocephalus? Select all that apply.
Headache
Dilated nonreactive pupils
Nausea/Vomiting
Altered LOC
Cushing's Triad
Photophobia