spina bifida

• spina bifida is a neural tube defect that occurs in the spinal cord and affects mainly the lumbar area
• the cause of spina bifida is unknown, but it may be due to genetic factors or environmental factors such as folic acid deficiency during pregnancy
• spina bifida can be prevented with increased folic acid intake
• there are 3 types of spina bifida: myelomeningocele, meningocele, and spina bifida occulta
• spina bifida occulta is mostly harmless but fat may deposit where the missing vertebrae are and cause a tethered spinal cord, the main concern is mobility
• spina bifida occulta is confirmed by MRI
• with spina bifida occulta, assess for tufts of dark hair, discoloration, and dimpling of skin
• meningocele spina bifida is less severe than myelomeningocele because the spinal cord isn't involved
• meningocele has an acorn size sac with cerebral spinal fluid that is prone to leakage, this sac cannot dry or crack
• meningocele is confirmed by MRI, CT scans, transillumination, and ultrasounds
• myelomeningocele has a grapefruit-sized sac that protrudes the spinal cord, increasing its severity
• monitor head circumference and fontanelles with myelomeningocele
• nursing interventions to keep the sac protected until surgery to prevent leakage include:

  keeping it moist with non-adherent sterile saline dressings

  placing pt in prone position

  avoiding diapers

  feeding with the head turned to the side