Clinical meaning
A ventriculoperitoneal (VP) shunt is a surgically implanted device that diverts excess cerebrospinal fluid (CSF) from the ventricles of the brain to the peritoneal cavity, where it is reabsorbed. Hydrocephalus occurs when CSF production exceeds absorption, or when flow is obstructed, causing ventricular dilation and increased intracranial pressure (ICP). The shunt system consists of a proximal catheter (in the ventricle), a one-way valve, and a distal catheter (in the peritoneum). The nurse monitors for signs of shunt malfunction and increased ICP, reports changes immediately, and assists with pre- and post-operative care.
Exam relevance
Risk factors: - Premature birth with intraventricular hemorrhage - Myelomeningocele (spina bifida) - Congenital CNS malformations (Dandy-Walker, Chiari malformation) - CNS infections (meningitis, ventriculitis) - Brain tumors obstructing CSF pathways - Post-surgical or post-traumatic hydrocephalus
Diagnostics: - Monitor head circumference and mark measurement location for consistency - Monitor vital signs and report bradycardia or irregular respirations - Report signs of increased ICP: persistent irritability, poor feeding, vomiting, bulging fontanelle - Observe for sunset eyes (downward deviation of eyes) - Report fever, which may indicate shunt infection - Monitor surgical incision for signs of infection