THE NERVOUS SYSTEM Overview: This case requires knowledge of

THE NERVOUS SYSTEM Overview: This case requires knowledge of… THE NERVOUS SYSTEM  Overview: This case requires knowledge of hydrocephalus, spina bifida, growth and development, as  well as an understanding of the client’s background, personal situation, and parent-child attachment  relationship. Client Profile Jerod is the name Joanna and Jim chose for their first child. Jim accompanied Joanna to all  of her prenatal visits. When the routine ultrasound was performed at 32 weeks’ gestation, Jerod was  diagnosed with hydrocephalus and a myelomeningocele. His parents were initially devastated, but  remained very excited about their son’s birth. Joanna was scheduled for a caesarean section at 38  weeks’ gestation and the couple were anxious about Jerod’s condition and his treatment following birth. Case Study Jerod is delivered by caesarean section and transferred to the pediatric intensive care unit  (PICU). On admission to the nursery he weighs 3.4 kg (7.5 lb) and is 8 cm (20 in.) in length. His vital signs  are: Temperature: 37° C (98.6° F) Pulse: 144 beats/minute Respirations: 40 breaths/minute He has  bulging fontanels and a high-pitched cry. His head circumference is 40 cm (15.8 in.) and his chest  circumference is 34 cm (13.4 in.). In the lumbar region of his spine, the nurse notes a sac-like projection.  When Joanna and Jim visit the nursery, they stroke Jerod and caress his fingers and toes. Joanna begins  to cry and comments to the nurse, “I so wanted to breastfeed Jerod, but now I guess I can’t.” s  1. Discuss the reason for Jerod being delivered by caesarean section.  2. Discuss the significance of Jerod’s clinical manifestations.  3. What is hydrocephalus?  4. What is a myelomeningocele and how is it related to hydrocephalus?  5. Discuss the incidence and etiology of hydrocephalus and myelomeningocele.  6. Discuss the complications associated with Jerod’s myelomeningocele.  7. What are the priorities of care for Jerod on admission?  8. Discuss Jerod’s parents’ actions when visiting Jerod in the nursery and how the nurse should respond  to Joanna’s concern about breastfeeding.  9. Discuss the priority nursing interventions when caring for Jerod’s myelomeningocele prior to surgery.  10. Jerod’s myelomeningocele is surgically repaired and a shunt is placed for his hydrocephalus. Discuss  the two types of shunts used to treat hydrocephalus and which is most common 11. Discuss the complications that may occur in a child with a ventriculoperitoneal (VP) shunt and an  atrioventricular (AV) shunt.  12. Discuss the teaching priorities for Jerod’s parents prior to his discharge from the hospital to home Health Science Science Nursing BSN 15

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