A 6-year-old child is admitted for revision of a ventriculoperitoneal shunt for noncommunicating hydrocephalus. What sign or symptom does the child have that indicates a revision is necessary
a. Tachycardia
b. Gastrointestinal upset
c. Hypotension
d. Alteration in level of consciousness
ANS: D
In older children, who are usually admitted to the hospital for elective or emergency shunt revision, the most valuable indicators of increasing intracranial pressure are an alteration in the child's level of consciousness, complaint of headache, and changes in interaction with the environment.
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