Post-Hemorrhagic Hydrocephalus in Pre-Term Infants Clinical Pathway — N/IICU
Post-Hemorrhagic Hydrocephalus in Pre-Term Infants Clinical Pathway — N/IICU
Nursing Care
Pre-Operative Care
Daily Care for All Patients
- Daily Head Circumference
- Fontanelle checks with care/vital signs
- Nursing neuro assessments with vital signs as per orders
Pre-Operative Care
- CHG bath and Johnson & Johnson head wash before OR
- Transport on GE warmer bed/ omnibed with the shuttle to maintain heat during transport; baby should wear hat and be on a transwarmer with warm blankets.
Post-Operative Care
Assessments
- Administer post-op antibiotics per orders (usually cefazolin q8 hours x 3 doses)
- Head of bed elevated for fresh post-op patient to prevent site leaking
- Assess site q 4 hours for leakage/drainage (no routine dressing over site)
- Monitor for seizures
- Monitor for infection
Bathing
- Johnson & Johnson wash with sterile water 2-3x daily for first 2 weeks and then daily until all sutures have dissolved per orders.
Caring for an External Drain
In addition to above:
- Monitor drainage hourly
- Neuro assessment hourly or per order
- ICP monitoring is not routine
Caring for a Reservoir
For tapping:
- Topical lidocaine per orders (must be > 5 kg or ≥ 30 weeks corrected age)
- Sucrose for procedural pain relief
- Containment for physical support
Consults
PT/OT