The nurse is caring for a newborn with a myelomeningocele. To protect the sac, the nurse should
The nurse is caring for a newborn with a myelomeningocele. To protect the sac, the nurse should
A. irrigate the sac with a cold sodium chloride (normal saline).
[2%]
B. apply petroleum ointment as a protective covering for the sac.
[4%]
C. cover the sac with moist, saline dressing.
[85%]
D. apply a dry dressing over the sac.
[9%]
Statistics
Subject/Lesson
Subject
Child Health
Lesson
Neurologic
Client Need
Test Plan
Reduction of Risk Potential
Related Topic
Potential for Complications from Surgical Procedures and Health Alterations
Item Type
Item Type
Application
Explanation
Choice C is correct. Before surgical closure, the sac is kept from drying by applying a sterile, moist, nonadherent dressing. The moistening solution is usually sterile normal saline. Dressings are changed frequently (every 2 to 4 hours), and the sac is closely inspected for leaks, abrasions, irritation, and signs of infection.
Choice A is incorrect. Irrigating the sac with cold sodium chloride (normal saline) could cause the newborn to develop cold stress. This is not recommended.
Choice B is incorrect. Prolonged use of petroleum jelly or ointments can result in the breakdown of the sac tissue. This is not recommended.
Choice D is incorrect. Dry dressings are irritating to the tissues of the myelomeningocele sac. Further, this may cause adherence to the sac and irritate the tissue.
Learning Objective
When caring for a newborn with a myelomeningocele prior to surgical intervention, recognize the need to apply a sterile, moist, nonadherent dressing to the sac.
Related Videos
2 Key Topics
Neural Tube Defects
31.9 Neurologic Disorders
Additional Info
✓ Myelomeningocele develops during the first 28 days of pregnancy when the neural tube fails to close and fuse.
✓ Most myelomeningoceles occur in the lumbar or lumbosacral area.
✓ The location and magnitude of the defect determine the nature and extent of neurologic impairment.
✓ Meningoceles are repaired early, especially if the sac is in danger of rupturing.
✓ While the newborn is awaiting surgical repair, the nurse should place the newborn in the prone position and keep the sac covered with a sterile, moist dressing.
