A newborn has been admitted to the intensive care unit with a diagnosis of myelomeningocele. The nurse could expect which of the following with the disorder?
Partial to complete paralysis in the lower extremities
Unilateral port-wine birthmark
A protruding sac containing abdominal contents
A fusion of cranial suture lines
The Correct Answer is A
Rationale:
A. Myelomeningocele is a type of spina bifida where there is a protrusion of the meninges and spinal cord through a defect in the vertebrae. This condition can result in partial to complete paralysis in the lower extremities due to the involvement of the spinal cord.
B. A unilateral port-wine birthmark is typically associated with conditions like Sturge-Weber syndrome, not myelomeningocele.
C. A protruding sac containing abdominal contents is characteristic of omphalocele, not myelomeningocele.
D. Fusion of cranial suture lines is not associated with myelomeningocele but rather with craniosynostosis.
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Correct Answer is C
Explanation
Rationale:
A. A complete blood count is not specifically required before administering the rubella vaccine.
B. Lead screening is not related to rubella vaccination and is not required for this purpose.
C. The rubella vaccine is a live attenuated vaccine, and it is important to ensure that the patient is not pregnant because the vaccine could potentially harm the fetus. Therefore, a pregnancy test is a necessary precaution.
D. Tuberculosis screening is not related to the rubella vaccination and is not required for this purpose.
Correct Answer is D
Explanation
Rationale:
A. There is no need to notify the provider if urine output is within the normal range.
B. Oral rehydration may not be necessary if the child is adequately hydrated.
C. A bladder scan is not required if the urine output is within the normal range.
D. Continue to monitor the client as the urine output is within the normal range. For a 3-year-old child (15 kg), normal urine output is 1-2 mL/kg/hr. This child’s output is approximately 1.3 mL/kg/hr, which is normal.