Care plan of a child with myelomeningocele and coexisting hydrocephalus – a case study/ Plan opieki nad dzieckiem z przepukliną oponowo -rdzeniową i współistniejącym wodogłowiem – opis przypadku
Journal Title: Medical Science Pulse - Year 2017, Vol 11, Issue 4
Abstract
Background: Due to the advances made by children who are born with myelomeningocele (open spina bifida), they have increased life expectancies. However, it is still important to understand the causes of neural tube defects that are presently poorly understood. The key period for the development of the neural tube is the first month of pregnancy, when a mother is often unaware of her pregnancy. That is one reason why the folic acid supplementation is advised for women of childbearing age, so that even an unborn child is not at risk of defects. Aim of the study: To discuss the substance of the myelomeningocele disease and to propose an exemplary nursing care plan for the patient with this type of spina bifida, who has been treated in hospital since birth. Case study: The case study is a description of a 2.5-year-old boy who was born with a myelomeningocele in the thoracic-lumbar area with co-existing hydrocephalus. Plastic surgery of myelomeningocele was performed at the first and second day of life. Rehabilitation of the child started immediately after healing of the wound. At 9 weeks of age, a ventriculoperitoneal shunt was implanted. Additionally, the decision was taken to install a tracheotomy tube. During the child’s stay in the ward it was necessary to double-plasty the wounds on his back. Due to the persistent symptoms of gastro-oesophageal reflux, the decision was taken to perform the anti-reflux and exposure of gastrostomy procedure. Also exteriorization of vesicocutaneous fistula was performed, due to recurring infections of the bladder due to neurogenic bladder. Currently, the boy still requires mechanical ventilation. He is fed by gastrostomy (PEG). He in quite good contact with the environment, he smiles, recognizes relatives and reacts to strangers. Conclusions: It is important to recognize the patient’s deficits/dysfunctions and to place appropriate nursing diagnoses. The scheduled, suitable for nursing interventions are subject to systematic evaluation and enable adjusting the care plan to the changing situation. Unfortunately, some damage in myelomeningocele is irreversible, nevertheless the professional nursing care makes it possible to meet the needs of a patient, whereas the level of proper care and observation of a child significantly improves its quality of life.<br/><br/>
Authors and Affiliations
Patrycja Nicpoń, Ewa Radwańska
Keywords
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