The nurse is caring for a neonate born with a myelomeningocele. ...

[mydiamond]

The nurse is caring for a neonate born with a myelomeningocele. Surgery to repair the defect is scheduled the next day. The most appropriate way to position and feed this neonate is to place him:
 
  a. Prone and tube feed.
  b. Prone, turn head to side, and nipple feed.
  c. Supine in infant carrier and nipple feed.
  d. Supine, with defect supported with rolled blankets, and nipple feed.

Question 2

A current recommendation to prevent neural tube defects is the supplementation of:
 
  a. Vitamin A throughout pregnancy.
  b. Multivitamin preparations as soon as pregnancy is suspected.
  c. Folic acid for all women of childbearing age.
  d. Folic acid during the first and second trimesters of pregnancy.

[juiceman1987]

Answer to Question 1

ANS: B
In the prone position, feeding is a problem. The infant's head is turned to one side for feeding. If the child is able to nipple feed, no indication is present for tube feeding. Before surgery, the infant is kept in the prone position to minimize tension on the sac and risk of trauma.

Answer to Question 2

ANS: C
The widespread use of folic acid among women of childbearing age is expected to decrease the incidence of spina bifida significantly. Vitamin A and multivitamin preparations do not have a relation to the prevention of spina bifida. Folic acid supplementation is recommended for the preconceptual period and during the pregnancy. Only 42 of women actually follow these guidelines.