NTDs: Encephalocele, Meningoele, and Myelomeningocele

Question 1

An encephalocele is…

Answer 1

herniation fo the brain and meninges through a defect in the skill resulting in a fluid-filled sac.

-brain tissue can be involved in an encephalocele

Question 2

Another name for a meningocele is….

Answer 2

spina bifida.

A meningocele is herniation of the brain containing the meninges but NOT the spinal cord.

Question 3

The most common NTD is…

Answer 3

myelomeningocele.

A myelmeningocele is when there is incomplete closure of the posterior vertebrae laminae.

A myelmeningocele will present as a protruding sac anywhere on the spinal cord. Within the sac will be CSF, meninges, AND a portion of the spinal cord.

Question 4

Patients with a NTD can present with urinary incontinence and/or poor bowel control. True or False?

Answer 4

True.
(rectal temps should be avoided in these patients prior to surgery and potentially after)

Surgery in an infant presenting with NTD will likely have surgery within 24 to 72 hours of birth (1 to 3 days).

Question 5

What are some pre-operative nursing considerations for a pt with NTD?

Answer 5

-assess for infection
-cont to assess the sac
-measure head circumference (increased ICP)
-prevent trauma to or drying of the sac
-avoid rectal temps

Question 6

What should be included in your post-operative assessment of a patient with NTD (corrected)?

Answer 6

-assess for paralysis
-assess for neurogenic bowel and bladder
-assess for increased ICP