The nurse reports to the healthcare provider signs of increased intracranial pressure in an infant with myelomeningocele who has which finding?
A.
A fontanelle that bulges with crying
B.
Increased respiratory rate
C.
A high-pitched cry
D.
Tachycardia
The Correct Answer and Explanation is:
The correct answer is C. A high-pitched cry.
Explanation:
Increased intracranial pressure (ICP) in infants, especially those with conditions like myelomeningocele, can manifest through various clinical signs. Understanding these signs is crucial for timely intervention and management. Myelomeningocele is a type of spina bifida where the spinal cord and nerves are exposed through a defect in the spine, which can lead to complications, including increased ICP.
A high-pitched cry is a key indicator of increased ICP in infants. This characteristic change in the cry is often described as a “cat-like” or “piercing” cry and reflects increased pressure within the cranial cavity. This sign is particularly important because it represents a neurological change in the infant’s usual behavior, suggesting that the increased ICP is affecting brain function.
A fontanelle that bulges with crying can be seen in infants with increased ICP, but it is less specific compared to a high-pitched cry. Bulging of the fontanelle is often assessed alongside other signs of increased ICP and may not be as immediate or consistent as changes in the cry.
Increased respiratory rate can be a response to various stressors, including pain or discomfort, but it is not as directly indicative of increased ICP. Respiratory changes can occur for many reasons, making it less specific for diagnosing ICP compared to other signs.
Tachycardia, or an increased heart rate, might occur in response to stress or discomfort but is not a primary indicator of increased ICP. It could be caused by other conditions or factors unrelated to intracranial pressure changes.
In summary, a high-pitched cry is a reliable and specific indicator of increased intracranial pressure in infants with conditions like myelomeningocele. This finding should prompt further evaluation and management to address the underlying issue causing the elevated ICP.