Spina bifida involves the failure of the neural tube to develop or close during embryonic development causing defects in the spinal cord and in the bones of the spine. There are two types of spina bifida: spina bifida occulta is the most common and is a defect in the closure without the herniation and exposure of the spinal cord or meninges at the surface of the skin in the lumbosacral area. While spina bifida cystica (meningocele or myelomeningocele) is a defect in the closure of a sac and herniated protrusion of meninges, spinal fluid and possibly some part of the spinal cord and nerves at the surface of the skin in the lumbosacral or sacral area.
Hydrocephalus is often related with spina bifida cystica. The extent of neurologic impairment are associated to the location and nerves involved in the defect and range from varying degrees of sensory deficits, to partial or total loss of motor function resulting in flaccidity, partial paralysis of lower extremities, and bowel and urinary incontinence.
There are several different treatments that can be used to manage symptoms or conditions associated with spina bifida such as surgery to close the opening in the spine which may be done during infancy or later, physiotherapy, speech and occupational therapy, use of assistive devices and mobility equipment, such as a wheelchair, or walking aids, and urinary and bowel management.
Nursing care planning goals for clients with spina bifida include prevent infection, maintain skin integrity, prevent trauma related to disuse, increase family coping skills, education about the condition, and support.
Here are seven (7) nursing care plans (NCP) and nursing diagnosis (NDx) for spina bifida:
- Impaired Urinary Elimination
- Bowel Incontinence
- Disturbed Body Image
- Interrupted Family Processes
- Risk for Infection
- Risk for Injury
Disturbed Body Image
May be related to
- Biophysical, psychosocial factor of child
Possibly evidenced by
- Feelings of helplessness and hopelessness
- Verbal expression of negative feelings about body and functional disabilities
- Inability in performing ADL
- Recurring hospitalizations
- Urinary/bowel incontinence
- Partial or complete paralysis
- Child will express feelings about disability.
- Child will identify at least one positive thing about own body.
|Assess child for feelings about strengths and weaknesses in performing ADL, social interaction, effect on self-concept.||Provides information about the potential for independence in thinking and functioning.|
|Encourage expression of feelings and concerns and support communication of the child with parents and peers.||Provides an opportunity to vent feelings to reduce anxiety and negative feelings.|
|Encourage parents to sustain support and care for the child.||Encourages acceptance of the child.|
|Encourage independence and maximize functioning with the use of aids for dressing, bathing, grooming, eating, mobility, toileting, and acknowledge on attempts at self-care activities.||Promotes ADL capability by use of assistive aids as needed depending on the disability.|
|Advise parents to maintain consistent behavior rules for the child as other children in the family and to integrate care and activities into the family routine.||Provides a sense of belonging to the family.|
|Notice any positive achievement and avoid mentioning negative comment.||Enhances body image and confidence.|
|Provide touching and hugging, age-appropriate activities with other children.||Conveys caring and concern for the child and enhances socialization.|
|Encourage and teach in the use of assistive aids for ADL.||Promotes independence and enhances body image.|
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- Nursing Diagnosis: The Complete Guide and List – archive of different nursing diagnoses with their definition, related factors, goals and nursing interventions with rationale.
Maternal and Newborn Care Plans
Nursing care plans related to the care of the pregnant mother and her infant. See care plans for maternity and obstetric nursing:
- Abruptio Placenta| 3 Care Plan
- Cesarean Birth | 10 Care Plans
- Cleft Palate and Cleft Lip | 6 Care Plans
- Dysfunctional Labor (Dystocia) | 4 Care Plans
- Elective Termination | 6 Care Plans
- Gestational Diabetes Mellitus | 4 Care Plans
- Hyperbilirubinemia | 4 Care Plans
- Labor Stages, Induced and Augmented Labor | 36 Care Plans
- Neonatal Sepsis | 5 Care Plans
- Perinatal Loss | 5 Care Plans
- Placenta Previa | 3 Care Plans
- Postpartum Hemorrhage | 8 Care Plans
- Postpartum Thrombophlebitis | 4 Care Plans
- Prenatal Hemorrhage | 7 Care Plans
- Prenatal Substance Dependence/Abuse | 6 Care Plans
- Precipitous Labor | 3 Care Plans
- Pregnancy Induced Hypertension | 6 Care Plans
- Premature Dilation of the Cervix | 3 Care Plans
- Prenatal Infection | 3 Care Plans
- Preterm Labor | 6 Care Plans
- Puerperal Infection | 4 Care Plans