A major nursing intervention for an infant born with myelomeningocele is to:
1. protect the sac from injury.
2. prepare the parents for the child's paralysis from the waist down.
3. prepare the parents for the closure of the sac at around 2 years of age.
4. assess for cyanosis.
1
1. Correct. A major preoperative nursing intervention for a neonate with a myelomeningo-cele is protection of the protruding sac from injury to prevent its rupture and resultant risk of CNS infection.
2. Incorrect. The long-term prognosis in an affected infant can be determined to a large ex-tent at birth, with the degree of neurologic dysfunction related to the level of the lesion, which determines the nerves involved.
3. Incorrect. A myelomeningocele should be surgically closed within 24 hours.
4. Incorrect. Although the nurse would assess for multiple potential problems in this infant, the major nursing intervention would be to protect the sac from injury.
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