A nurse is caring for an infant post operative closure of a myelomeningocele. Which intervention is essential for providing basic care and comfort following myelomeningocele sac closure?

Avoiding any oral feedings for the first 24 hours to prevent aspiration

Applying direct pressure to the surgical site if bleeding occurs.

Frequent diaper changes and keeping the incision site clean and dry

Allowing the infant to lie flat on their back to promote spinal alignment

Answer and Explanation

The Correct Answer is C

A.   Avoiding oral feedings may not be necessary unless there are specific complications. The focus should be on preventing aspiration, but not necessarily withholding feedings.
B.   Direct pressure should not be applied to the surgical site unless directed by a provider, as this could cause further complications.
C.   Frequent diaper changes and keeping the incision site clean and dry is essential to prevent infection and protect the surgical site.
D.   The infant should be positioned according to the provider's orders to avoid pressure on the surgical site and spinal cord, but lying flat may not always be necessary.

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Correct Answer is A

Explanation

A. Bacterial meningitis is highly contagious, and isolation precautions are necessary to prevent the spread of the infection to others. This should be the nurse's first action to protect both the child and others.
B. While antibiotics are crucial in treating bacterial meningitis, initiating isolation protocols is the first priority to prevent transmission to others.
C. A lumbar puncture is needed to confirm the diagnosis of meningitis, but isolation protocols should be established first to prevent spread.
D. Blood cultures are important for diagnosing bacterial meningitis but are secondary to ensuring proper isolation to prevent contagion.

A. "All recently used clothing, bedding, and towels must be washed in warm water." B. "Toys that can't be dry cleaned or washed must be thrown out." C. "I will treat all the family members to be on the safe side." D. “We need to comb through our child's hair with a fine-toothed comb to remove the dead lice and nits after using the medicated shampoo."

Correct Answer is D

Explanation

A. This is also correct, but the focus of the question is on the treatment of the child's hair itself.
B. Non-washable toys should be bagged for 2 weeks, not thrown out.
C. While treating all family members is common, only those with active infestations need treatment.
D. This is the correct action after using a medicated shampoo for lice treatment. A fine-toothed comb should be used to remove lice and nits (eggs) from the child's hair.

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A nurse is caring for an infant post operative closure of a myelomeningocele. Which intervention is essential for providing basic care and comfort following myelomeningocele sac closure?

Nursing Test Bank

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