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NURS 3512 - Class 7-12 > Week 10 - Neural Tube Defects > Flashcards

Week 10 - Neural Tube Defects Flashcards

1
Q

what is the neural tube

A
  • an embryonic structure that ultimately forms the spinal cord and brain
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2
Q

what is a neural tube defect

A
  • group of abnormalities resulting from abnormal development of the brain, spine and/or spinal column
  • during the development of an affected embryo, the neural tube does not close completely as it should, resulting in a hole somewhere along the spinal column
  • causes varying degrees of defect
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3
Q

what are 2 types of neural tube defects

A
  1. spina bifida occulta

2. spina bifida cystica

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4
Q

what is spina bifida occulta

A
  • neural tube defect that affects the lumbar sacral area: L5-S1
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5
Q

what are symptoms of spina bifida occulta (5)

A
  • less visible abnormalities
  • skin manifestations instead:
  • port wine mark
  • soft lipomas
  • dimples in the lumbar region
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6
Q

what are signs & symptoms of spina bifida cystica

A
  • has an external saclike protrusion
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7
Q

what are 2 types of spina bifida cystica

A
  1. meningocele

2. myelomeningocele

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8
Q

what is meningocele

A
  • includes an external saclike protrusion of meninges and spinal fluid
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9
Q

what is myelomeningocele

A
  • includes an external saclike protrusion of meninges, spinal fluid, and nerves
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10
Q

what are signs of myelomeningocele (i think that’s what she’s referring to in the lecture?? either this or spina bifida cystica in general) (4)

A
  • neuromuscular defects
  • impacts bowel & bladder function
  • lower limb paralysis
  • associated deformities
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11
Q

what are associated deformities r/t myelomeningocele (5)

A
  • scoliosis
  • hip dislocation
  • lower limb paralysis
  • hydrocephaly
  • VS –> inability to control & regulate temp, cardiac, and resp function
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12
Q

what is the cause of neural tube defects (5)

A
  • unknown but can be related to:
  • prenatal meds
  • radiation
  • maternal malnutrition (decreased FA)
  • genes
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13
Q

what diagnostic studies are used for neural tube defects (5)

A
  • MRI
  • CT
  • US (prenatally)
  • neuro assessment
  • assess meningeal sac
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14
Q

what disciplines are involved in nursing care for myelomeningocele (5)

A
  • neuro
  • neurosurgery
  • peds
  • urology
  • ortho
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15
Q

what is included in nursing care for myelomeningocele(2)

A
  • manage associated deformities (ex. hydrocephalus, limb paralysis)
  • manage bowel & urinary malformations (lumbar & sacral area)
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16
Q

what are pts w myelomeningocele at risk for (2)

A
  • meningitis

- hypoxia

17
Q

what is treatment for myelomeningocele

A
  • surgery to close the sac
18
Q

when is surgery for myelomeningocele done (3)

A
  • sometimes pre-natal
  • otherwise within 72 hrs
  • within 24hr if sac leaking CSF
19
Q

what is included in myelomeningocele pre-op nursing care (5)

A
  • assess & care for sac
  • neuro & motor assessments
  • ROM exercises
  • u/o monitoring
  • monitor for & prevent pressure sores/skin care (esp. bc may not be diapered)
20
Q

how should a pt w myelomeningocele be fed

A
  • prone
21
Q

what is included in care for the sac (4)

A
  • prevent trauma to the sac (caution: rupture of sac during transport)
  • regulate temp
  • prevent from drying out/keep moist
  • prevent infection
22
Q

how is trauma to the sac prevented (5)

A
  • prone position
  • no pressure on the sac
  • don’t bump
  • diapering may be contraindicated
  • no blankets, clothes
23
Q

describe how temp may be regulated in a pt w myelomeningocele

A
  • isolette/warmer (bc no clothes or covers)
24
Q

describe how the sac is left from drying out/kept moist (2)

A
  • keep moist w NS soaked dressing

- change dressings often

25
Q

describe how to prevent infection in a pt w myelomeningocele (2)

A
  • antibiotics

- cleanse sac

26
Q

what is u/o monitoring imp for a pt w myelomeningocele (3)

A
  • risk of bladder dysfunction
  • risk for UTI
  • foleys
  • etc.
27
Q

describe post-op care for a pt w myelomeningocele (6)

A
  • same as pre-op
  • watch for signs of CSF leakage at site
  • monitor for bleeding
  • monitor for infections
  • VS
  • ABCs
28
Q

describe prognosis of myelomeningocele (3)

A
  • varying degrees of impairment (including motor & GU)
  • intelligence not typically effected
  • many can have a degree of independent living

NURS 3512 - Class 7-12 (49 decks)

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