PEDIATRIC NURSING DISORDERS NOTES

SPINA BIFIDA- CNS Defect
 Neural tube failure to close during embryonic development
Cause: Unspecific
Contributing Factors:
 Late maternal age
 Poor nutrition/vitamin A deficiency (folic Acid)
 Genetic influence
Diagnostic Test
 Amniocentesis
 UTZ
 Myelogram
 AFP- ALPHA FETO PROTEIN – Dx of choice
o N (<15 ng/ml), ↑ in spina bifida, ↓ down syndrome
2 TYPES
1. Spina Bifida Occulta – no sac; dimpling at the base of the spine
 Tuffs of hair, NO PARALYSIS, no surgery

2. Spina Cystica- sac, COULD BE PARALYSIS, requires surgery
 Meningocele- CSF, meninges
 Meningomyocele- CSF, meninges, nerves, spinal cord
o PARALYSIS, SAC IS VERY THIN- sac will be prone to rapture and leakage
o Most relevant Nursing Diagnosis 1st 120 of life: Risk for infection

Transillumination- to check & measure the amount of CSF
No Transillumination- AP can’t measure the CSF accurately
- the portion of spinal cord has entered the sac
LUMBO-SACRAL AREA- most common site

ASSESSMENT
1. Visible spinal defect
2. flaccid paralysis of the legs
3. Altered bladder and bowel function
4. Hip and Joint deformities

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