Question

A newborn with a myelomeningocele is being transferred immediately from the birthing room to the neonatal intensive care unit (NICU). What is the initial nursing intervention?

Answer 1

The initial nursing intervention should be as following:

Applying a sterilized saline gauze serves to restrict infection while retaining the membranes moistened. Although charging for paralysis should be made though this is not the preference. Usage of antibiotics is not administered prophylactically. After this procedure, the newborn requires extra routine attention due to the outpouching of the meninges.

Answer 2

Applying sterile, moist nonadherent dressings is done to prevent drying and breakage of the sac; any opening increases the risk for infection of the central nervous system. Diapering is contraindicated until the defect is repaired; the diaper may irritate the sac and cause rupture, predisposing the infant to infection. The infant is generally placed in a neutral position to reduce pressure on the affected area. The legs are abducted to counteract subluxation because the infant is unable to move the legs.