A newborn is diagnosed with a myelomeningocele. Which of the following is the priority nursing intervention immediately after birth?

A. Provide scheduled analgesics and encourage nonpharmacologic strategies is correct. Children with sickle cell disease often experience recurrent pain episodes due to vaso-occlusion. Managing pain effectively involves scheduled analgesics, such as acetaminophen or opioids for severe pain, to maintain consistent relief, along with nonpharmacologic strategies like heat application, relaxation techniques, and distraction. This approach prevents pain escalation and improves quality of life.

B. Administer medication only when the child requests it is incorrect because children with chronic pain may underreport pain or wait until it is severe. Scheduled dosing ensures consistent pain control and prevents unnecessary suffering.

C. Limit physical activity to prevent pain episodes is incorrect because while extreme exertion can trigger a pain crisis, normal activity should be encouraged as tolerated to maintain mobility, muscle strength, and overall health. Over-restriction can negatively affect development and psychosocial well-being.

D. Encourage the child to ignore the pain is incorrect because ignoring pain can lead to delayed treatment, increased suffering, and potential complications such as prolonged vaso-occlusive crises. Pain should be acknowledged and managed appropriately.

A. Overstimulation of parasympathetic nerves resulting in rapid bowel transit is incorrect because Hirschsprung’s disease is characterized by decreased or absent bowel motility, not increased motility. Rapid transit would lead to diarrhea rather than constipation and failure to pass meconium.

B. Absence of ganglionic nerve cells in a portion of the colon, causing a lack of peristalsis is correct because Hirschsprung’s disease is a congenital disorder caused by aganglionosis. The affected segment of the colon lacks enteric (Meissner and Auerbach) ganglion cells, resulting in failure of peristalsis, functional obstruction, and accumulation of stool proximal to the affected area.

C. Obstruction caused by hypertrophy of intestinal smooth muscle is incorrect because this mechanism is more consistent with conditions such as pyloric stenosis, not Hirschsprung’s disease. Hirschsprung’s is a neurologic defect, not a muscle hypertrophy problem.

D. Inflammation of the intestinal mucosa leading to motility loss is incorrect because Hirschsprung’s disease is not an inflammatory condition. While inflammation may occur secondary to bowel obstruction, it is not the primary pathophysiologic cause.