Master Spina Bifida Interventions with Picmonic for Nursing RN

Infants with spina bifida should be placed in a prone position to prevent pressure on the lumbar sac. Since the sac is vulnerable to rupture leading to infection of the spinal cord, precautions should be implemented to prevent complications.

The lumbar sac on the infant's lower back is covered with a moist sterile dressing to minimize the risk of infection. Infants with myelomeningocele may develop meningitis, leading to brain injury and possibly death.

Hydrocephalus is common among children with spina bifida. The child’s inability to drain fluid from the brain leads to fluid accumulation that may cause neurological problems or mental retardation. Measuring the child's head circumference is critical for early detection and intervention for hydrocephalus. To relieve pressure on the brain, a shunt may be surgically inserted to drain excess fluid into the abdomen.

In infants, a bulging, tense fontanel is a sign of increased intracranial pressure (IICP). Increased ICP may develop into hydrocephalus and lead to neurological complications.

Other congenital malformations commonly occur in patients with spina bifida. Additional conditions may include hydrocephalus, scoliosis, hip dislocation, and clubfoot (talipes varus or valgus).

Spina bifida may affect the ability to voluntarily relax the muscle sphincters that hold stool in the rectum. Children experiencing lack of bowel control have issues with fecal incontinence. An antegrade continence enema (ACE) procedure may be performed to help eliminate stool.

Neurogenic bladder is a common issue in children with myelomeningocele. Since children with this condition are unable to voluntarily relax the muscle sphincters that hold urine in the bladder, they may require intermittent catheterization to periodically drain urine from the bladder. Teach the child and parent techniques for emptying the bladder to prevent overfilling that may lead to kidney injury.