Question

A nurse is performing a newborn assessment. Which of the following images should the nurse identify as an indication of spina bifida occulta?

A. The nurse should identify this as an image of spina bifida occulta.
External indications of this neural tube defect include a dimpled area over the defect and the presence of a birthmark or hairy patch above the area.
B. The nurse should identify this as an image of spina bifida manifesta in the form of a myelomeningocele that is closed. External indications of this neural tube defect include a herniated sac over the site of the defect that is covered with skin.
C. The nurse should identify this as an image of spina bifida manifesta in the form of a myelomeningocele that is open. External indications of this neural tube defect include an open area over the defect that allows for leakage of cerebrospinal fluid and entry of microorganisms.
D. The nurse should identify this as an image of Mongolian spots. These bluish-black pigmented areas are most commonly found on the buttocks and back of newborns of Mediterranean, Asian, African, and Latin American ethnicity and can be incorrectly identified as areas of ecchymosis

Answer 1

In a newborn assessment, the nurse identifies spina bifida occulta through indications such as a dimple, birthmark, or hairy patch above the spinal defect. Spina bifida occulta is less severe than other forms and usually does not affect the spinal cord or nerve function.

Step-by-step explanation:

The nurse should identify Option A as an image of spina bifida occulta. This mildest form of spina bifida is characterized by external indications such as a dimple or a birthmark, and sometimes a hairy patch over the defect. Although the vertebral bones do not fully surround the spinal cord, the spinal cord itself is typically not affected, which often results in no functional differences, and hence the condition is 'occulta' or hidden.

Spina bifida occulta differs significantly from the more severe types such as meningocele and myelomeningocele, which involve the formation of a cystic protrusion at the defect site and can result in severe neurological symptoms. Moreover, folate supplementation during early pregnancy is essential to prevent the risk of neural tube defects like spina bifida.