Question

Formulate a nursing care plan for the preoperative and postoperative care of a child with myelomeningocele.

Answer 1

Preoperative

Risk for Hypothermia related to the disease condition.

Possibly evidenced by

• Loss of heat and fluid from large area of exposed sac.
• Cool skin.
• Body temperature lower than normal range.

Desired outcome

• Childs temperature will remain above 97.8° F

Nursing interventions

• Monitor vital signs.
• Provide rafiant warmer.
• Educate parents about the appropriate amount of clothing required for the child.
• Asses temperature of the extremity.

Post-operative

Risk for infection related to entry of pathogenic organisms due to bacterial invasion of the neural tube sac.

Desired outcome

• Child will not experience Infection

Nursing Interventions

• Assess neural tube sac for breaks or leakage of CSF
• Assess for fever, irritability, nuchal rigidity.
• Observe changes in the wound following surgical repair of the defect.
• After surgery, cleanse round with as antiseptics as ordered and change dressings when needed using sterile technique for at least 24 hours.