PICU: Dandy-Walker; ICP monitoring

[BBQvegan]

Hi all,

I am not sure whether to post here in Neuro ICU or PICU. I am a nursing student in the pediatric rotation. I cared for a 2 y.o. child with Dandy Walker syndrome who had just had a 3rd ventriculostomy. No shunt was placed, but an ICP catheter was placed and hooked to an art line and monitor. This was a closed system that was hooked to a plastic contraption where the physician could withdraw CSF for analysis. Otherwise, there was no drainage; only monitoring of ICP.

I understand this is the system of ICP monitoring that was available before the newer technology. Do many hospitals have this system? What is the name for it? Why was it hooked to an art line? How does it work? Is there anything else I should know about it?

I also want to understand his CSF lab results. RBCs 1600 (normal = 0-10). And neutrophils 100 (normal = 0-6). Is this due to the trauma/inflammation caused by the burr hole and ventriculostomy? What else might we expect to see?

In this case, I have identified main nursing priorities:

1. Monitor and maintain ICP levels below 25 mm Hg.

2. Administer antibiotics and observe for signs of infection.

3. Control pain and nausea.

4. Provide comfort and emotional support to pt and mother.

Are there other important interventions I am overlooking? And anything else I need to consider?

Thank you so much!

[BBQvegan]

Also want to know why this pt would be getting D5NS with 20 mEq KCl. His K+ levels were normal.