Neural Tube Defects

The most common type of neural tube defect is:

a myelomeningocele

How might a myelomeningocele affect urine or bowel control?

May cause a lack of bowel (neurogenic bowel) or bladder control (neurogenic bladder)

An infant is born with a myelomeningocele. The nurse notices constant dribbling of urine. This is likely because:

of overflow incontinence; basically, the bladder is full but the child doesn't have bladder control, so any excess just leaks out

Which extremities may be affected by a myelomeningocele?

The lower extremities

Spina bifida occulta is:

a type of spina bifida without a protruding sac. The only outward signs might be a dimple, nevi, or a tuft of hair near the base of the spine. It may help to remember that occult blood in stool refers to blood in stool that can't be seen.

How does spina bifida increase the risk of lower extremity skin breakdown?

Many children with spina bifida have less movement and sensation from the lower extremities. Also, they have to be kept prone while waiting for repair.

Measuring urine output is especially important in children with spina bifida because:

many children with spina bifida have impaired bladder control, so a dry diaper for a long period is concerning (although a wet diaper may simply be from overflow incontinence)

Measuring head circumference is especially important in children with spina bifida because:

many children with spina bifida also develop hydrocephalus

Assessing the fontanelles is especially important in children with spina bifida because:

many children with spina bifida also develop hydrocephalus

Because the infant with a myelomeningocele is unable to be covered with a blanket the nurse should:

place the infant in an incubator or warmer

When an infant is in a warmer, the infant is at increased risk of:

dehydration (think about how you would feel spending all day under a hot lamp!)

Nursing Alert: For an infant with spina bifia, it is MOST important to assess for:

1. early signs of infection (e.g. temperature instability, irritability, lethargy), then 2. signs of increased intracranial pressure

When taking the temperature of an infant with spina bifida it is important to avoid:

measuring rectal temperatures which can cause rectal prolapse

What kind of dressing should be placed over the myelomeningocele sac?

The dressing should be sterile, moist, nonadherent

A rupture of myelomeningocele sac would greatly increase the risk of:

meningitis

Before surgical repair of a myelomeningocele, the nurse should position the infant:

prone, with hips slightly flexed

A mother of an infant born with a myelomeningocele tells the nurse she wants to cuddle with the infant. What is the best response?

"Cuddling is not safe at this time, but you may caress the child"

What allergy is strongly associated with spina bifida?

Latex allergy