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Which of the following are important parts of the nursing care plan for an infant with myelomeningocele?

A.

accurate intake and output, daily head circumference, and assessing parent- infant bonding

B.

chest physiotherapy, saline gavage, and family counseling

C.

head circumference, Glascow Coma Scale, and urinary catheterization

D.

frequent vital signs, renal checks, and patient contact isolation

Answer and Explanation

The Correct Answer is A

Rationale:
A. Infants with myelomeningocele are at risk for hydrocephalus, so daily head circumference is essential to monitor for increased intracranial pressure. Monitoring intake and output is important due to the risk of neurogenic bladder, and assessing parent-infant bonding supports emotional development and attachment.
B. Saline gavage and chest physiotherapy are not typical interventions unless respiratory issues are present.
C. While urinary catheterization might be needed, the Glasgow Coma Scale is not routinely used for infants unless there's a neurologic crisis.
D. Contact isolation is not standard unless there’s an infection. Renal checks are important but not complete enough without other key care plan components.


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Related Questions

Correct Answer is C

Explanation

Rationale:
A. A metabolic screening test does not assess the metabolic rate.
B. Emotional or psychological disorders are not detected through newborn metabolic screening.
C. Newborn metabolic screening is a vital test that checks for numerous rare, but serious inherited metabolic and genetic disorders, such as phenylketonuria (PKU), congenital hypothyroidism, galactosemia, and others. Early detection allows for prompt treatment to prevent severe complications like intellectual disability, organ damage, or death.
D. While infections can affect development, they are not the primary focus of the newborn metabolic screening test.

Correct Answer is C

Explanation

Rationale:
A. Learning disabilities may occur but are not as consistently associated with myelomeningocele as other complications.
B. Urinary tract infections can occur due to neurogenic bladder, but they are considered secondary complications.
C. Hydrocephalus is a very common long-term complication of myelomeningocele, occurring in up to 80–90% of cases. It often requires a ventriculoperitoneal (VP) shunt.
D. Skin breakdown is a concern in immobile children but is not as prevalent or immediately life-altering as hydrocephalus.

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