shunt post-op care

prmenrs, RN · Mar 3, 2005

Ny son has had a shunt since he was a baby. When there is a sudden shift in intracranial pressure (either increased or decreased), patients can have headaches, nausea and vomitting. So, the usual post-op routine is to keep them flat the first 24hrs, then start increasing the HOB a little @ a time, as tolerated. You don't say how old your daughter is, I think it's easier the younger the child is. My son didn't have a revision til he was 9, it took 3 days for the pressure to "equilibrate"; his preference was to be prone and flat, everytime they tried to increase HOB, he barfed. The second time it took 6 days. In any case, once the pressure equilibrates, you won't know it's even there.

If your daughter suddenly starts vomitting, c/o headache, call the doc. (My son came in my room one morning and announced, "Mom, I have a headache, and I'm throwing up". He also had a fever. He was in the hospital that afternoon.

You should expect to have CAT scans/MRIs periodically to watch for ventricular enlargement (I've been making a major assumtion that your daughter's shunt is from her brain to somewhere else; IF NOT, IGNORE EVERYTHING I'VE SAID, and accept my apologies!). It can occur very slowly, and, in that case, may not have the same symptoms.

Good luck, and if I can help you, pm me.

lizzie58 · Mar 4, 2005

Ny son has had a shunt since he was a baby. When there is a sudden shift in intracranial pressure (either increased or decreased), patients can have headaches, nausea and vomitting. So, the usual post-op routine is to keep them flat the first 24hrs, then start increasing the HOB a little @ a time, as tolerated. You don't say how old your daughter is, I think it's easier the younger the child is. My son didn't have a revision til he was 9, it took 3 days for the pressure to "equilibrate"; his preference was to be prone and flat, everytime they tried to increase HOB, he barfed. The second time it took 6 days. In any case, once the pressure equilibrates, you won't know it's even there.
If your daughter suddenly starts vomitting, c/o headache, call the doc. (My son came in my room one morning and announced, "Mom, I have a headache, and I'm throwing up". He also had a fever. He was in the hospital that afternoon.
You should expect to have CAT scans/MRIs periodically to watch for ventricular enlargement (I've been making a major assumtion that your daughter's shunt is from her brain to somewhere else; IF NOT, IGNORE EVERYTHING I'VE SAID, and accept my apologies!). It can occur very slowly, and, in that case, may not have the same symptoms.
Good luck, and if I can help you, pm me.

thank you for your input, my daughter is 29..she had a stroke on 11/29/04. due to some ventricular enlargement it was decided to place a shunt. this was done on 03/01/05. actually, she's doing quite well except for the sx which i am assuming are associated with the post-op course. the difficult part is that the residents, etc do not seem to know much nor care much about the sx associated with the placement. if she is almost flat it's better, but she's on 2mg ms every 2 hours??? it's tough being a nurse when it's your daughter...or son, etc. thanks again.