Spina Bifida, Cerebral Palsy - Pediatric Nursing - Nervous System Disorders | @LevelUpRN

Summary

Cathy from Level Up RN reviews spina bifida and cerebral palsy, focusing on their causes, types, signs, treatment, and nursing care.

Spina Bifida

Spina bifida is a neural tube defect in which a baby’s spinal cord does not develop properly in utero.

Risk factors mentioned:

• Insufficient folic acid intake during pregnancy
• Maternal diabetes
• Maternal drug use

Types:

1. Spina bifida occulta: The defect is covered by skin and may not be visible, though a tuft of hair, dimple, or birthmark may appear over the affected area.
2. Meningocele: A sac or cyst protrudes over the spinal cord and contains the meninges and cerebrospinal fluid.
3. Myelomeningocele: A protruding sac contains the meninges, cerebrospinal fluid, and part of the spinal cord.

Diagnosis: Prenatal ultrasound may identify the condition. Elevated AFP in pregnancy blood work may indicate the possibility of a neural tube defect such as spina bifida.

Treatment: Surgical closure of the defect as soon as possible. If the condition is identified prenatally, surgery may be performed in utero.

Nursing Care for an Infant With Meningocele or Myelomeningocele

• Protect the protruding sac with a sterile, saline-moistened, nonadherent dressing.
• Avoid pressure on the sac.
• Position the infant prone, with hips flexed.

Family Teaching and Potential Complications

• Be aware of possible hydrocephalus and latex allergy.
• Reduced sensation increases the risk of pressure injuries and burns.
• Bladder dysfunction is common and may require intermittent catheterization.

Cerebral Palsy

Cerebral palsy is a neurological disorder affecting body movement and muscle coordination. The video describes it as resulting from abnormal brain development in utero or a hypoxic brain injury that damages the cerebral cortex and affects motor function.

Signs and symptoms may include:

• Ataxia, or lack of coordination
• Muscle spasticity
• Impaired gait
• In severe cases, intellectual disability, seizures, or impaired swallowing, speech, vision, or hearing

Treatment and support may include:

• Botox or intrathecal baclofen to address muscle spasticity
• Physical and occupational therapy to support the child’s functioning
• Speech therapy
• Assistive devices
• Possible orthopedic surgery

Review Quiz

1. Insufficient intake of folic acid during pregnancy increases the risk of spina bifida.
2. An infant with a meningocele should be positioned prone with hips flexed.
3. A cyst containing the meninges, cerebrospinal fluid, and part of the spinal cord is a myelomeningocele.

Speaker and Source

• Cathy Parkes, presenter, representing Level Up RN.