A nurse is caring for a newborn who has a myelomeningocele and is admitted to the newborn intensive care unit (NICU) to await surgery. Which of the following nursing goals is priority in the care of this infant?

A. Place the infant in prone position.

This option is incorrect. Placing the infant in the prone position (lying on the stomach) could put pressure on the spinal lesion, potentially causing discomfort or complications. It's important to minimize pressure on the affected area in infants with spina bifida.

B. Cover the infant's lesion with a dry cloth.

This option is incorrect. While keeping the lesion clean and dry is important for preventing infection, simply covering it with a dry cloth may not provide adequate protection. Proper wound care techniques, such as using sterile dressings and cleaning the area with prescribed solutions, are typically necessary to prevent infection and promote healing.

C. Feed the infant through an NG tube.

This option is incorrect. While infants with severe forms of spina bifida may have difficulty feeding due to associated complications, such as difficulty swallowing or weak sucking reflexes, feeding through a nasogastric (NG) tube is not a standard intervention for spina bifida itself. Feeding methods would depend on the specific needs and abilities of the infant, and may involve breastfeeding, bottle-feeding, or other methods under the guidance of healthcare professionals.

D. Diapering over a low defect will keep the infant free from infection.

This option is correct. Diapering over a low defect (the opening in the spine caused by spina bifida) helps to keep the area clean and reduce the risk of infection. By properly covering the defect with a diaper, exposure to urine and feces, which can increase the risk of infection, is minimized. Additionally, regular diaper changes and proper hygiene practices are essential for preventing complications in infants with spina bifida.

A. Overriding aorta: In Tetralogy of Fallot, the aorta is positioned over the ventricular septal defect (VSD), rather than solely over the left ventricle as it would be in a normal heart. This is called overriding aorta, which allows blood from both the right and left ventricles to enter the aorta.

B. Pulmonary stenosis: This is a critical component of Tetralogy of Fallot. Pulmonary stenosis refers to narrowing of the pulmonary valve or the area just below it, which restricts blood flow from the right ventricle to the pulmonary artery. This results in decreased blood flow to the lungs for oxygenation.

C. Left ventricular hypertrophy: This choice is not typically associated with Tetralogy of Fallot. Left ventricular hypertrophy refers to an enlargement or thickening of the muscular wall of the left ventricle of the heart. It is often seen in conditions where the left ventricle has to work harder to pump blood, such as in hypertension or aortic stenosis, but it is not a characteristic feature of Tetralogy of Fallot.

D. Ventricular septal defect: This defect is one of the four components of Tetralogy of Fallot. A ventricular septal defect (VSD) is a hole in the septum, the muscular wall that separates the left and right ventricles of the heart. In Tetralogy of Fallot, the VSD allows oxygen-poor blood from the right ventricle to flow directly into the left ventricle and out to the body.