A 2-day-old infant with hydrocephalus returns from surgery following placement of a ventriculoperitoneal shunt. Which nursing interventions should the practical nurse (PN) implement during postoperative care? (Select all that apply.)

A. Measure head circumference daily: Measuring the head circumference helps detect changes in intracranial pressure and assess shunt function. A sudden increase may indicate shunt malfunction or obstruction, making daily monitoring an essential part of postoperative care. B. Place in Trendelenburg position: The Trendelenburg position increases intracranial pressure and should be avoided in infants with a ventriculoperitoneal shunt. The preferred position is supine with the head slightly elevated to promote cerebrospinal fluid drainage. C. Irrigate shunt and pump valve every 12 hours: Shunt irrigation is contraindicated because it introduces a risk of infection and mechanical damage to the shunt system. Only trained neurosurgical personnel should manipulate or assess shunt function under sterile conditions. D. Document strict intake and output: Accurate monitoring of intake and output helps assess fluid balance and detect complications such as dehydration or fluid overload, which can affect cerebrospinal fluid dynamics and overall recovery. E. Monitor body temperature every 4 hours: Regular temperature monitoring is vital because fever may signal shunt infection or meningitis, both serious postoperative complications. Early detection of temperature changes allows for prompt medical intervention.