Spina bifida And Nursing Care Plan


Spina bifida

Vertebral column fails to close during intrauterine development

Three forms:

1. Spinal bifida occulta

2. Meningocele

3. Myelomeningocele

Spina bifida occulta: Failure of vertebral arch to close, a dimple occurs on the sacral area, may be covered  by a tuft of hair.

Meningocele: Protrusion of membranes of the meninges. Meninges consist of: dura  mater, arachnoid, and pia mater) covered by thin membrane. No paralysis because spinal cord is not involved.

Myelomeningocele: Protrusion of the meninges and spinal cord. Covered by thin  membrane, Extent of paralysis depends on the location of the defect. Results in hydrocephalus

Medical Management

Same day surgery: correct defect, minimize complications, and prevent  infection, Encourage folic acid 4mg Po with future pregnacies (conception-6 weeks)

Nursing Interventions:

Primary intervention after birth of infant with meningocele,and myelomeningocele is to cover defect with a sterile, saline-soaked dressing

Maintains moisture

Decrease infection

Encourage parents to become involved with infant care ASAP

Learn techniques: feeding, ROM exercises, positioning, catheterization, skin care,

Nursing diagnosis

•Potential for infection R/T presence of infective organisms, non-epitheliazed meringue sac, paralysis.

•Potential for trauma R/T delicate spinal lesion

•Potential impaired skin integrity R/T paralysis, continual dribbling of urine

•Potential for complications R/T impaired circulation of CSF or neuro-muscular impairment

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Posted in Neurology, Nursing Care Plans, Nursing Intervention, Pediatrics

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