neural tube defects
what would you look for while assessing for a neural tube defect
- a defect on the back - movement below the defect to determine the degree of paralysis - examine for a relaxed anus or dribbling of urine
what is spina bifida usually seen as (visually)
-a dimple on the back -may have a tuft of coarse hair over it
define meningocele
-a protrusion of the meminges and spinal fluid through the spina bifida -covered by skin or a thin membrane
what prenatal care helps to protect the fetus against neural tube defects
-folic acid
what is recommended for prevention of neural tube defects and what is the dose
-folic acid -400 mcg / day
paralysis does not occur with this neural tube defect, explain why
-meningocele -the spinal cord is not involved
this neural tube defect may be accompanied by paralysis, explain why
-myelomeningocele -the spinal cord is involved
what should the nurse do for a neural tube defect protruding through the skin
-place infants torso in a sterile plastic bag -cover the defect with a sterile saline dressing and plastic to prevent drying
folic acid will have a greater effect on preventing neural tube defects if taken when
-prior to conception -in early pregnancy
what position should a infant with a protruding neural tube defect be placed in
-prone or on the side - to help prevent trauma to the sac
define myelomeningocele
-protrusion of a membrane covered sac through the spina bifida -meninges, nerve roots, spinal cord and spinal fluid all protrude into the sac
name the three types of neural tube defects
-spina bifida occulta -meningocele -myelomeningocele
what is the therapeutic management for meningocele and myelomeningocele
-surgery as soon as possible -antibiotics are given - to prevent infection
define spina bifida
defective closure of the bony spine that encloses the spinal cord
what is spina bifida occulta
failure of the vertabral arch to close
this is the worst type of neural tube defect to have
myelomeningocele
this is the most common type of neural tube defect
spina bifida
what area of the body would you assess for a neural tube defect
the back
what determines the level of paralysis a infant will have with myelomeningocele
the location of the defect