A nurse is caring for a newborn who has a myelomeningocele and is admitted to the newborn intensive care unit (NICU) to await surgery. Which of the following nursing goals is priority in the care of this infant?
A.
Promote maternal-infant bonding
B.
Provide age-appropriate stimulation.
C.
Educate the parents about the defect.
D.
Maintain integrity of the sac.
The correct answer and Explanation is :
The correct answer is D. Maintain integrity of the sac.
Explanation:
In the care of a newborn with myelomeningocele, maintaining the integrity of the sac is the highest priority nursing goal. Myelomeningocele is a type of spina bifida where the spinal cord and nerves are exposed through a defect in the spinal column. This exposure poses significant risks, including infection, further neurological damage, and injury to the spinal cord and nerve roots.
Keeping the sac intact is crucial for several reasons. First, an intact sac minimizes the risk of infection, which can be life-threatening for the infant. Infections can lead to complications such as meningitis or sepsis, significantly increasing morbidity and mortality. The nurse must ensure that the sac is covered with a sterile, moist dressing to protect it from contaminants and prevent drying out, which could also lead to rupture.
Secondly, maintaining the integrity of the sac helps preserve the neurological function of the infant. Damage to the exposed spinal cord can result in severe neurological deficits, which may affect mobility, sensation, and bowel or bladder control later in life. The nurse must monitor the sac closely for any signs of leakage, irritation, or changes in appearance, which could indicate potential complications.
While promoting maternal-infant bonding, providing age-appropriate stimulation, and educating parents about the defect are important aspects of holistic care, they do not take precedence over the immediate need to protect the infant’s physical health. Once the integrity of the sac is secured and the infant is stabilized, the nurse can focus on other goals, such as supporting family bonding and education, which are vital for the long-term care and development of the child.