You admit L.M., a 2-month-old girl with a history of hydrocephalus and ventriculoperitoneal (VP) shunt
placement 1 month earlier.
Her parents report that she has been more irritable than usual and for the past
3 days has fed poorly and has had emesis five or six times every day.
Explain the pathophysiology of hydrocephalus and cerebrospinal fluid (CSF) imbalance.
CSF is produced and absorbed in the ventricles of the brain. Hydrocephalus is the result of too
much CSF accumulation in the ventricles or impaired absorption. This may result from impaired CSF
absorption or CSF flow obstruction. Possible causes include congenital defects in the brain such as
Chiari malformation, swelling from trauma (shaken baby syndrome) or infection, and tumors. As
extra CSF collects in the ventricles, additional pressure builds in the cranial vault.
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The nurse knows that hematopoiesis occurs in what part of the musculoskeletal system?
a. Cancellous tissue b. Collagen matrix c. Red marrow d. Yellow marrow
The type of incontinence that is characterized by a large residual urine volume is which of the following?
a. Urge incontinence b. Stress incontinence c. Overflow incontinence d. Functional incontinence
The nurse is preparing to discharge to home a patient who is a construction worker and who has been prescribed a sulfonamide. Which of the following instructions would be most important for this particular patient?
a. "Make sure to use sunscreen." b. "Take the medication with food." c. "Report any muscle pain immediately." d. "Report any nausea or stomach upset."
The nurse has applied EMLA cream as ordered. How does the nurse determine whether the cream has achieved its purpose?
A) Assess the skin for redness. B) Note any blanching of skin. C) Lightly tap the area where the cream is. D) Gently poke the child with a needle.