After a shunt procedure for increased intracranial pressure in a child, which finding is most concerning?

Marked irritability in a child following a shunt procedure for increased intracranial pressure is a significant concern because it may indicate complications such as increased intracranial pressure, infection, or shunt malfunction. After such a procedure, a child is monitored closely for signs of these post-operative complications, and irritability can be a non-specific but concerning symptom.

Increased intracranial pressure can manifest as behavioral changes, including significant irritability, as the child's body responds to the discomfort or distress caused by rising pressure in the skull. This symptom may suggest that the shunt is not functioning as intended, or there may be an underlying issue that requires immediate medical intervention.

While a pulse of 100 beats per minute, a temperature of 99.4° F, and complaints of pain can signify various levels of concern, they are not as directly indicative of serious complications as marked irritability. A slight elevation in temperature may be normal post-operatively, and a pulse in that range is typically considered within normal limits for a child. Complaints of pain are also expected after surgery, but they can usually be managed. Therefore, it is the marked irritability that stands out as a critical symptom that warrants further assessment and intervention.