Which is the priority nursing intervention for an infant diagnosed with myelomeningocele?
A.
Educating caregivers on sensory impairment.
B.
Preventing infection.
C.
Correction of joint contractures.
D.
Measuring daily head circumference.
The Correct answer and Explanation is:
he correct answer is B. Preventing infection.
Explanation:
Myelomeningocele, a type of spina bifida, is a congenital neural tube defect where a portion of the spinal cord and its surrounding structures protrude through an opening in the vertebral column. This condition poses several significant risks for the affected infant, with infection being one of the most critical concerns.
Importance of Infection Prevention:
The primary focus in the management of myelomeningocele is infection prevention, particularly meningitis and other life-threatening infections. The exposed neural tissue and meninges are highly vulnerable to bacterial invasion. The sac may be covered with a thin membrane or be open, exposing the spinal cord and nerves to the external environment. Without appropriate measures, microorganisms can enter the central nervous system, leading to severe infections that can result in long-term neurological damage or even death.
Priority Nursing Interventions:
Sac Protection: To prevent infection, the sac must be protected from rupture and contamination. The nurse should apply a sterile, moist, non-adherent dressing over the sac and change it regularly. This keeps the sac moist and reduces the risk of tissue breakdown and subsequent infection.
Aseptic Technique: All procedures involving the infant should be performed using strict aseptic technique. This includes hand hygiene before handling the infant, using sterile gloves when changing dressings, and ensuring all equipment that comes into contact with the sac or the infant is sterile.
Monitoring for Signs of Infection: The nurse should vigilantly monitor the infant for any signs of infection, such as fever, irritability, changes in the sac’s appearance (e.g., redness, drainage, or swelling), and alterations in neurological status.
Educating Caregivers: While education about sensory impairment (Option A) and the importance of monitoring head circumference for hydrocephalus (Option D) is crucial, preventing infection takes precedence because of the immediate risk it poses to the infant’s life. Joint contracture correction (Option C) is also important but is not an immediate priority compared to infection prevention.
Conclusion:
Preventing infection is the highest priority for an infant with myelomeningocele because of the high risk of meningitis and other severe infections due to the exposed spinal cord and surrounding tissues. Proper nursing interventions aimed at safeguarding the sac and maintaining a sterile environment are critical in ensuring the infant’s safety and improving outcomes.