Spina bifida is a neural tube defect (NTD) that is characterized by a gap in the spine due to improper development. It is apparent at birth and occurs during the process of neural tube development. The neural tube is a structure that eventually develops into the brain and the spinal cord. This structure forms during the early days of pregnancy and proper development is critical. However, in babies with spina bifida, the neural tube develops improperly and fails to close, therefore, leaving a gap that causes complications that affect the spinal cord and the spine. A portion of the tube either undergoes incomplete development or fails to close. There are three main types of spina bifida namely meningocele, spina bifida occulta, and myelomeningocele.
Signs and symptoms
The signs and symptoms of spina bifida include comprise physical and neurological problems. Physical problems include leg weakness and paralysis, abnormal eye movement, skin irritations, visible spinal defect, hip and joint deformities, bladder and bowel control challenges, skin irritations, poor kidney function, orthopedic abnormalities, and urinary tract infections. Studies have shown that people with spina bifida also have an abnormality of the cerebellum. In others, there is incidence of hydrocephalus that occurs due to the displacement of the cerebellum thus affecting the proper flow of cerebrospinal fluid. As a result, there is an accumulation of excess fluid in the brain. There is abnormal development of corpus callosum and cortex abnormalities emerge. Young people with spina bifida have difficulties with executive functions such as planning, memory, organization, and initiation. Other weaknesses include problem solving, visual planning, abstraction, and poor cognitive flexibility. Students with the disorder experience difficulties in school especially in areas such as mathematics and reading.
Treatment modalities
There is no definite treatment for spina bifida. However, there are several treatment modalities that treat its symptoms or associated conditions. Treatment options include surgery, therapy, the use of assistive devices, and treatment for bowel and urinary problems. Surgery is usually conducted immediately after birth in order to close the opening in the spine that is caused by improper development of the neural tube. In addition, it is conducted to treat hydrocephalus, prevent infection, and prevent further damage of the nervous tissue. Therapies such as physiotherapy and occupational therapy are used in order to help patients become independent and carry out their daily tasks effectively. In certain cases, treatment can be conducted during pregnancy. Prenatal treatment can be carried out in two ways namely open fetal surgery and fetoscopy. These methods are not common because of the high risks they pose to mothers and babies such as scarring of the uterus and preterm birth respectively.
Appropriate nursing actions
Appropriate nursing actions that need to be carried out with regard to spina bifida include provision of supportive care, proper monitoring of motor function, extensive and active treatment, and rehabilitative therapy. Providing patients with supportive care is necessary because many of them encounter problems with mobility. It is also important to monitor their motor function in the lower extremities. Nurses should conduct examinations such as muscle strength and joint range of motion. In addition, they should be monitored in order to identify any deviations from proper development. Other nursing actions include measuring head circumference, assessing the sac and measuring the lesion, assessing neurological system, assessing and monitoring for increasing ICP, and assessing the patient for hip and joint deformities. Rehabilitative therapies to encourage, develop, and maintain independence should be provided consistently.
Patient education
In providing appropriate to education about the defect, I would ensure that patients understand the causes, signs and symptoms, and the treatment modalities available for spina bifida. I would also make sure that they understand how to manage and prevent it. Bladder management, bowel management, bracing, and orthotics are important aspects of spina bifida management that patients need to know about. Patient education would aim at helping individuals become independent and lead happy lives without needing too much assistance from family members.
Complications and effect in the pediatric client
Complications associated with spina bifida include bladder and kidney problems, skin problems, latex allergy, and psychological problems. Spina bifida causes challenges with storing and passing urine due to bladder and kidney defects. These could lead to kidney stones, recurrent urinary tract infections and hydronephrosis. Reduced sensation in legs can occur due to destruction f nerve function. Many people with the disease develop allergy to latex and psychological problems because the experiences of the disease are traumatic.
Conclusion
Spina bifida is a serious defect that affects the central nervous system. It results from improper development of the neural tube during embryonic development. Common signs and symptoms include paralysis of the legs, altered bowel function, visible spinal defect, and hip and joint deformities. The most common treatment modality is surgery and can be done either during pregnancy or after birth. It is critical for patients to undergo physical and occupational therapies in order to help them become independent and live happy lives without too much assistance. Nurses can help patients by administering medication, assessing hip and joint deformities, and monitoring them regularly.
Works Cited
Anderson, Elizabeth, and Bernie Spain. The Child with Spina Bifida. New York: Routledge, 2016. Print.
Foster, Mark. Spina Bifida Treatment and Management. 2016. Web.
Lutkenhoff, Marlene. Children with Spina Bifida: A Parent’s Guide. New York, 2008. Print.
Sandler, Adrian. Living with Spina Bifida: A guide for Families and Professionals. New York: University of North Carolina Press, 2009. Print.
Watson, Stephanie. Spina Bifida. New York: The Rosen Publishing Group, 2008. Print.
Zychowicz, Michael. Orthopedic Nursing Secrets. New York: Elsevier Health Sciences, 2003. Print.