Health Promotion and Maintenance
27. A newborn arrives in a neonatal intensive care unit with a myelomeningocele. A physician writes orders to keep the infant in the prone position. A nurse should know that the most important rationale behind this order is to:
. Prevent infection.
. Promote circulation in the lower extremities.
. Prevent trauma to the meningeal sac.
. Promote comfort.
Test-Taking Tip
Two of the main priorities of care for an infant with myelomeningocele are to prevent infection and prevent damage to the meningeal sac. To identify the most important, think about which complication is more apt to cause irreversible damage.
Content Area: Child Health, Neurological; Integrated Process: Nursing Process, Planning; Cognitive Level: Analysis; Client Need/Subneed: Physiological Integrity/Reduction of Risk Potential/Potential for Complications from Surgical Procedures and Health Alterations
Health Promotion and Maintenance
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Answer 1 is incorrect because, although prevention of infection is a top priority, trauma to the sac could permanently affect the function of the lower extremities while infection may be treated with antibiotics. Answer 2 is incorrect because the rationale for placing the infant in the prone position is not to promote increased circulation. Answer 3 is correct because the most important rationale for the prone position is to prevent damage to the meningeal sac, which could result in damage to the nerves and infection. Answer 4 is incorrect because, although a newborn may prefer the prone position, the rationale for this intervention is not to promote comfort.