1
Q
What does the sac contain with spina bifida meningocele?
A
- sac contains meninges and spinal fluid but no neural elements, nerves, or spinal cord
- no neurologic deficits
2
Q
- neural tube fails to close
- may be anywhere along the spinal column (lumbar and lumbosacral areas are the most common)
- may be diagnosed prenatally or at birth
A
myelomeningocele
3
Q
What does the sac contain with myelomeningocele spina bifida?
A
meninges
spinal fluid
nerves
4
Q
What does the initial management of myelomeningocele look like?
A
- multidisciplinary
- intensive nursing care
- prevent infection
- assess neurologic and associated anomalies (hip dysplasia, clubfoot, genitourinary deformity)
- surgery 12 to 72 hours post birth
- prevent stretching of other nerve roots to prevent further damage
- promote family bonding
5
Q
Pre-op nursing management for spina bifida.
A
- cover sac with moist sterile dressing to prevent infection
- thermoregulation
- no pressure on sac
- avoid contamination (urine/feces)
- latex precautions
6
Q
Explain spina bifida post-op care.
A
- prone for 7 days (some side lying)
- foley then to intermittent cath
- protect incision from stool and urine
- antibiotics
- watch for leaks
- daily head circumference and weekly head ultrasounds (hydrocephalus)
- Meds: urecholine to reduce urinary retention and solace to soften the stool
- long term care
7
Q
When will fetal surgery take place for spina bifida fetus?
A
19-26 weeks
8
Q
This develops as a result of an imbalance between CSF production and absorption resulting in enlarged ventricles and an increase in intracranial pressure.
A
hydrocephalus
9
Q
What is the etiology of hydrocephalus?
A
- obstruction or absorption impairment due to:
- infection
- intraventricular hemorrhage
- tumor or other structural abnormality
- prematurity
10
Q
What is hydrocephalus commonly associated with?
A
myelomeningoceal spina bifida
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