Which of the following would the nurse include in the pre-operative plan of care for an infant with myelomeningocele?
A) Positioning supine with a pillow under the buttocks
B) Covering the sac with saline-soaked non-adhesive gauze
C) Wrapping the infant snugly in a blanket
D) Applying a diaper to prevent fecal soiling of the sac
B
Response:
For the infant with a myelomeningocele, saline-soaked non-adhesive gauze or antibiotic-soaked gauze is used to keep the sac moist. The infant is positioned prone, with a folded towel under the abdomen, so that the urine and feces flow away from the sac. A warmer or isolette is used to keep the infant warm. Blankets are avoided because they could place excess pressure on the sac. Diapering may be contraindicated to avoid placing pressure on the sac.
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