Question

a nurse assesses a 4 - month - old with hydrocephalus. which finding is expected?
a. bulging fontanels and sunset eyes
b. normal growth with delayed milestones only
c. sunken fontanels
d. small head circumference

Explanation:

Hydrocephalus in infants is characterized by an abnormal accumulation of cerebro - spinal fluid. This leads to increased intracranial pressure. Bulging fontanels are a sign of increased intracranial pressure, and "sunset" eyes (where the sclera is visible above the iris) occur due to pressure on the cranial nerves and displacement of the eyes. Normal growth with only delayed milestones is not the most typical finding. Sunken fontanels are seen in dehydration, not hydrocephalus. A small head circumference is not associated with hydrocephalus; in fact, head circumference often increases due to the fluid accumulation.

Answer:

A. Bulging fontanels and "sunset" eyes