o Administer prescribed antiseizure agents; monitor antiseizure
medication blood levels.
o Observe for status epilepticus, which may occur after any intracranial
surgery.
Infections
o Urinary tract infections
o Pulmonary infections related to aspiration secondary to depressed level
of responsiveness; may result in atelectasis and aspiration pneumonia
o CNS infections (postoperative meningitis, CSF shunt infection)
o Surgical site infections/septicemia
Venous thrombosis
o Assess for pain, redness, warmth, and edema.
o Apply sequential compression device.
o Administer anticoagulant therapy as prescribed.
Leakage of CSF
o Differentiate between CSF and mucus.
Collect fluid on Dextrostix; if CSF is present, the indicator will
have a positive reaction, as CSF contains glucose.
Assess for moderate elevation of temperature and mild neck
rigidity.
o Caution patient against nose blowing or sniffing.
o Elevate head of bed as prescribed.
o Assist with insertion of lumbar CSF drainage system if inserted to
reduce CSF pressure.
Ventricular catheters may be inserted in the patient undergoing
surgery of the posterior fossa (ventriculostomy); the catheter is
connected to a closed drainage system.
Administer antibiotics as prescribed.
o Gastrointestinal ulceration (probably caused by stress response); monitor
for signs and symptoms of hemorrhage, perforation, or both.Evaluation
Expected patient outcomes
Demonstrates normal breathing pattern
o Absence of crackles
o Demonstrates active swallowing and coughing reflexes
Attains/maintains fluid balance
o Takes fluids orally
o Maintains weight within expected range
Compensates for sensory deprivation
o Makes needs known
o Demonstrates improvement of vision
Exhibits absence of complications
o No evidence of increased ICP
o Opens eyes on request
o Obeys commands
o Has appropriate motor responses
o Shows increasing alertness
o No evidence of rhinorrhea, otorrhea, or CSF leakage
o Absence of fever