Discharge Instructions for Hydrocephalus Following Shunt Placement (Child)

 Home care

• Give your child pain medicines as your healthcare provider directs.

• Feed your child their regular diet unless you are told otherwise.

• Wash your child’s incision each day with mild soap. Rinse the incision with water and gently pat it dry.

• Don’t allow your child to soak in the bathtub or a swimming pool until the incision is fully healed.

• Allow your child to resume normal activities gradually after returning home.

• Be aware that if your child needs an MRI, the newer shunts are MRI compatible. Check with your healthcare provider to be sure. Ask about a card that has important information about your child's device. The card often includes a model and serial number.

Follow-up

Make a follow-up appointment as advised.

When to call your child's healthcare provider

Call your healthcare provider right away if your child has any of the following:

• High-pitched cry or increased irritability

• Trouble with sucking, drinking, or eating

• Fever (see Fever and children, below)

• Stiff neck (refusing to bend or move the neck or head)

• Trouble breathing

• Seizures

• Head injury

• Headache or visual disturbance

• Bleeding, drainage, or pus at the incision site

• Loss of appetite, vomiting, or stomach pain

• Confusion or sleepiness that occurs more than usual

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

• Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

• Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

• Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

• Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

• Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use a rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.

Below is when to call the healthcare provider if your child has a fever. Your child’s healthcare provider may give you different numbers. Follow their instructions.

When to call a healthcare provider about your child’s fever

For a baby under 3 months old:

• First, ask your child’s healthcare provider how you should take the temperature.

• Rectal or forehead: 100.4°F (38°C) or higher

• Armpit: 99°F (37.2°C) or higher

• A fever of ___________as advised by the provider

For a child age 3 months to 36 months (3 years):

• Rectal or forehead: 102°F (38.9°C) or higher

• Ear (only for use over age 6 months): 102°F (38.9°C) or higher

• A fever of ___________ as advised by the provider

In these cases:

• Armpit temperature of 103°F (39.4°C) or higher in a child of any age

• Temperature of 104°F (40°C) or higher in a child of any age

• A fever of ___________ as advised by the provider