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Central nervous system defects include a range of disorders resulting from malformations of the neural tube during embryonic development. What is Spina Bifida?
ClassificationSpina bifida can be classified into three: Types of Spina Bifida. Image: Wikipedia.org
PathophysiologyNeural tube defects are the result of a teratogenic process that causes failed closure and abnormal differentiation of the embryonic neural tube.
Statistics and IncidencesThe occurrence of spina bifida in the United States and internationally are estimated in the following: Image via: cdc.gov
CausesThe etiology in most cases of spina bifida is multifactorial, involving genetic, racial, and environmental factors, in which nutrition, particularly folic acid intake, is key.
Clinical ManifestationsClinical manifestations may vary depending on the type of spina bifida.
Assessment and Diagnostic FindingsAssessment and laboratory findings of a patient with spina bifida may reveal the following:
Surgical ManagementMany specialists are involved in the treatment of these newborns, especially in the case of myelomeningocele.
Nursing ManagementHighly skilled nursing care is necessary in all aspects of the newborn‘s care. Nursing AssessmentA routine newborn examination is conducted with emphasis on neurologic impairment.
Nursing DiagnosesBased on the assessment data, the major nursing diagnoses are:
Nursing Care Planning and GoalsThe major goals for the patient are to:
Nursing InterventionsNews that the newborn child has a condition such as spina bifida can naturally cause the family to feel grief, anger, frustration, fear and sadness, however, nurses are there to help the family cope and understand the defect the child has.
EvaluationExpected outcomes from the patient include:
Documentation GuidelinesDocumentation for a patient with spina bifida may include:
Practice Quiz: Spina BifidaHere’s a practice quiz for spina bifida. Please visit our nursing test bank page for more NCLEX practice questions. 1. Spina bifida is one of the possible neural tube defects that can occur during early embryological development. Which of the following definitions most accurately describes meningocele? A. Complete exposure of spinal cord and meninges. B. Herniation of spinal cord and meninges into a sac. C. Sac formation containing meninges and spinal fluid. D. Spinal cord tumor containing nerve roots. 1. Answer: C. Sac formation containing meninges and spinal fluid.
2. The mother of Gian, a preschooler with spina bifida tells the nurse that her daughter sneezes and gets a rash when playing with brightly colored balloons, and that she recently had an allergic reaction after eating kiwifruit and bananas. The nurse would suspect that the child may have an allergy to: A. Bananas B. Latex C. Kiwifruit D. Color dyes 2. Answer B. Latex.
3. Nurse Marianne is caring for an infant with spina bifida. Which technique is most important in recognizing possible hydrocephalus? A. Measuring head circumference. 3. Answer A. Measuring head circumference.
4. A pregnant client, age 32, asks the nurse why her doctor has recommended a serum alpha fetoprotein. The nurse should explain that the doctor has recommended the test: A. Because it is a state law B. To detect cardiovascular defects C. Because of her age D. To detect neurological defects 4. Answer: D. To detect neurological defects Alpha fetoprotein is a screening test done to detect neural tube defects such as spina bifida. The test is not mandatory, as stated in answer A. It does not indicate cardiovascular defects, and the mother’s age has no bearing on the need for the test, so answers B and C are incorrect. 5. A nurse is performing an admission assessment on a newborn infant with a diagnosis of spina bifida (myelomeningocele). A priority nursing assessment for this newborn is: A. pulse rate B. palpation of the abdomen C. specific gravity of the urine D. head circumference measurement 5. Answer: D. head circumference measurement Newborn infants with spina bifida (myelomeningocele type) are at risk for hydrocephalus; therefore, the head circumference should be measured to obtain a baseline.
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