MENINGOCELE/ MYELOMENINGOCELE Description of the disorder Priority Nursing Diagnosis and why Nursing Assessment / Clinical Manifestations Nursing Plan/ Goals/ Outcomes Nursing Interventions Nursing Evaluations Patient and Family teaching Conclusion/ Summary Cites four (4) APA format references (at least 5 years old) i want all the element above to be describe separate, each of the element in separate paragraph.
MENINGOCELE/ MYELOMENINGOCELE:
Meningocele and myelomeningocele are two forms of spina bifida, a neural tube defect that occurs during fetal development. Meningocele refers to the protrusion of the meninges through a defect in the spine, while myelomeningocele involves the protrusion of both the meninges and the spinal cord. These conditions result from the incomplete closure of the neural tube, a structure that eventually develops into the brain and spinal cord. The exact cause of these disorders is not fully understood, but a combination of genetic and environmental factors is believed to play a role.
Priority Nursing Diagnosis:
A priority nursing diagnosis for individuals with meningocele/myelomeningocele is Risk for Infection related to the exposed spinal cord or meninges. This diagnosis is essential because the exposed tissue can increase the risk of infection, which could potentially result in complications such as meningitis or sepsis.
Nursing Assessment / Clinical Manifestations:
Assessment of a patient with meningocele/myelomeningocele involves evaluating various aspects such as the location and size of the defect, associated neurological deficits, and any signs of infection or associated conditions. Clinical manifestations may vary depending on the extent and location of the defect. In the case of meningocele, there may be a visible sac filled with cerebrospinal fluid, while myelomeningocele can present with a sac containing the spinal cord, nerves, meninges, and cerebrospinal fluid. Neurological deficits such as paralysis, muscle weakness or spasticity, sensory deficits, and bowel or bladder dysfunction may also be present.
Nursing Plan/Goals/Outcomes:
The nursing plan for individuals with meningocele/myelomeningocele includes the following goals: prevention of infection, maintenance of skin integrity, promotion of mobility and independence, management of neurological deficits, and provision of emotional support to the patient and family. The desired outcomes include the absence of infection, intact skin and prevention of pressure ulcers, improved mobility and functional abilities, optimal management of neurological deficits, and adequate emotional adaptation to the diagnosis.
Nursing Interventions:
To prevent infection, the nurse should ensure strict aseptic technique during dressing changes, provide education on proper hand hygiene, and monitor for signs and symptoms of infection. To maintain skin integrity, regular repositioning, use of pressure-relieving devices or mattresses, and proper hygiene practices should be implemented. Physical therapy and assistive devices may be necessary to promote mobility and independence.
To manage neurological deficits, the nurse should collaborate with the healthcare team to develop a comprehensive plan that may include medication management, positioning strategies, and referrals to specialized professionals such as occupational or speech therapists. Emotional support should be provided to the patient and family through active listening, empathy, and information sharing regarding available resources and support groups.
Nursing Evaluations:
The nurse should regularly evaluate the patient’s condition, monitor for signs of infection, assess skin integrity, document improvements in mobility and functional abilities, and observe for any psychological adaptation to the diagnosis. Evaluations should be documented and shared with the healthcare team to guide further interventions or modifications to the plan of care.
Patient and Family Teaching:
Education plays a crucial role in the care of individuals with meningocele/myelomeningocele. The nurse should provide information to the patient and family regarding the condition, its management, prevention of complications, and available resources. This may include teaching about proper hygiene and wound care techniques, strategies for maintaining skin integrity, medication administration, bowel and bladder management, and techniques for promoting mobility and independence. Additionally, emotional support should be offered to address the psychological impact of the diagnosis and guidance provided to help the family cope with the lifelong care needs of the patient.
In conclusion, meningocele and myelomeningocele are serious neural tube defects that require comprehensive nursing care. By addressing the priority nursing diagnosis, conducting thorough assessments, implementing appropriate interventions, evaluating outcomes, and providing education and support, nurses can contribute to the overall well-being and functional outcomes of individuals with these conditions. It is crucial for healthcare professionals to remain updated with the latest evidence-based practices and guidelines to ensure the provision of high-quality care to this unique population.
References:
1. Cornet C, Rittler M, Janvier D. Fetal myelomeningocele repair: State of the art. Open J Obst/Gynecol. 2017;7(10):1016-1025.
2. Adzick NS. Fetal surgery for spina bifida: past, present, future. Semin Pediatr Surg. 2013;22(1):10-17.
3. Mann JR, Raifu AO, Robinson K, et al. Association between maternal exposures during pregnancy and the risk of selected major birth defects. Journal of Perinatology. 2013;33(1):17-22.
4. Bainbridge R, Parr M, Johnson K, et al. Using a paediatric cerebrospinal fluid algorithm to investigate children with suspected intrathecal synthesis of antibodies. J Neurol Neurosurg Psychiatry. 2013;84(12):12.