A nurse is caring for a newborn who has exstrophy of the bladder.
Which of the following actions should the nurse take prior to the beginning of surgical correction?
A.
Restrict the newborn’s fluid intake.
B.
Keep the newborn in a side-lying position.
C.
Cover the newborn’s bladder with a sterile, non-adherent dressing.
D.
Exert gentle pressure on the newborn’s bladder with sterile gauze.
E.
Exert gentle pressure on the newborn’s bladder with sterile gauze.
The Correct answer and Explanation is:
The correct answer is C. Cover the newborn’s bladder with a sterile, non-adherent dressing.
Explanation
Exstrophy of the bladder is a congenital defect where the bladder is exposed outside the abdominal wall, leading to several complications, including infection and injury. Prior to surgical correction, it is essential to protect the exposed bladder to minimize these risks and provide optimal care.
Covering the newborn’s bladder with a sterile, non-adherent dressing serves several purposes. First, it helps to protect the delicate tissues of the bladder from trauma and contamination. The exposure can lead to increased risk of infection due to environmental bacteria, so maintaining a sterile barrier is crucial. A non-adherent dressing ensures that the underlying tissues are not further damaged when the dressing is changed, promoting healing.
Restricting fluid intake (Option A) is not a standard action in this context. While it might seem intuitive to limit fluid to reduce bladder volume, proper hydration is important for overall health, and restrictions can lead to dehydration.
Keeping the newborn in a side-lying position (Option B) may provide some comfort, but it does not specifically address the critical need to protect the exposed bladder.
Exerting gentle pressure on the newborn’s bladder with sterile gauze (Options D and E) is contraindicated. Applying pressure can risk damaging the already vulnerable tissue of the bladder. The goal is to minimize trauma and protect the area until surgical intervention can be performed.
In summary, covering the bladder with a sterile, non-adherent dressing (Option C) is the most appropriate action for the nurse to take prior to the surgical correction of exstrophy of the bladder. This action safeguards against infection and injury, providing a foundation for the upcoming surgical procedure.