Discharge teaching for a school-age child with a ventriculoperitoneal shunt is considered successful when the parents identify which sign as signaling a blocked shunt?

Discharge teaching for a school-age child with a ventriculoperitoneal shunt is considered successful when the parents identify which sign as signaling a blocked shunt?

• A. Decreased urine output with stable intake
• B. Tense fontanelle and increased head circumference
• C. Elevated temperature and reddened incisional site
• D. Irritability and increasing difficulty with eating

Answer: (D)

Blockage of a ventriculoperitoneal shunt raises intracranial pressure, and in school-age children this often shows up as changes in behavior and appetite. Irritability and increasing difficulty with eating signal mounting brain pressure and prompt urgent assessment to prevent injury from elevated ICP. The other signs point to different issues: a tense fontanelle and increased head circumference are signs of raised ICP in infants whose skull sutures aren’t fused; fever with a reddened incision suggests shunt infection rather than blockage; and decreased urine output with stable intake isn’t related to shunt function.

Blockage of a ventriculoperitoneal shunt raises intracranial pressure, and in school-age children this often shows up as changes in behavior and appetite. Irritability and increasing difficulty with eating signal mounting brain pressure and prompt urgent assessment to prevent injury from elevated ICP. The other signs point to different issues: a tense fontanelle and increased head circumference are signs of raised ICP in infants whose skull sutures aren’t fused; fever with a reddened incision suggests shunt infection rather than blockage; and decreased urine output with stable intake isn’t related to shunt function.