1
NUR 1050 PEDIATRIC NURSING FINAL EXAM
STUDY GUIDE CONDITIONS & CARE 2026 JUST
RELEASED VERSION
What are the 2 kinds of spina bifida and what are signs and symptoms?
(MEGAN T.R )Pg # 1016 Spina bifida is one of the type of myelodysplasia
which is a malformation of the spinal canal in the cord. Spina bifida
is specifically where the bony spine doesn’t close all the way. Two
types of Spina bifida are Spina Bifida Occulta and Spina Bifida
Cystica.
Cystica= Visible External Sac -Two types of cystica which are
meningocele (sac has meninges and spinal fluid), and
myelomeningocele (meninges, spinal fluid, but on top has nerves
encased in it)myelomeningocele serious form of cystica.
Occulta= No external sac that is visible
BOX 30.5 ↓
Downloaded by Denis Professor ()
,2
Clinal manifestations SB Occult- (MEGAN T.R) “A Cutaneous
manifestation along the spine, something seen on the skin on the
spinal column most specifically lower part of spinal column (skin
dimple, port wine angiomatous nevi port wine stain), dark tuffs of
hair, soft subcutaneous lipoma. problems w/ gait. Possible to see
bowel/bladder issues but, not in comparison to cystica.
Downloaded by Denis Professor ()
,3
Clinical manifestations SB Cystica- (MEGAN T.R) “Partial paralysis of the
lower extremities, bowel/bladder issues.”
(BOOK)- Pg # 1014-1023- Abnormalities that derive from the
embryonic neural tube (neural tube defects NTD constitute the largest
group of congenital anomalies with multifactorial inheritance. Normally
the spinal cord and cauda equina are encased in a protective sheath of
bone and meninges FIG. 30.5A. Failure of neural tube closure produces
defects of varying degrees BOX 30.4. They may involve the entire length
of the neural tube or may be restricted to a small area. Two of the
defects, acephaly and Spina Bifida, occur in association with each other
more often than would be expected by chance, suggesting a common
origin. Midline defects involving failure of the osseous (bony) spine to
close are called spina bifida, the most common defect of the CNS. SB is
categorized into two types: SB Occult and SB Cystica. SB Occulta refers
to a defect that is not visible externally. It occurs most commonly in the
lumbosacral area. SB Cystica refers to a visible defect with an external
saclike protrusion. The two major forms of SB cystica are meningocele,
which encases meninges and spinal fluid but no neural elements, and
myelomeningocele or (meningomyelocele) which contains meninges,
spinal fluid, and nerves. BOX 30.5
Clinical manifestations of Spina Bifida- Spina bifida cystica= Sensory
disturbances usually parallel to motor dysfunction.
Below second lumbar vertebra: Flaccid, partial paralysis of lower
extremities. Varying degrees of sensory deficit. Overflow incontinence
with constant dribbling of urine. Lack of bowel control. Rectal prolapse
(sometimes) Below third sacral vertebra: No motor impairment,
bladder and anal sphincter paralysis. Joint deformities (sometimes
produced in utero): Talipes valgus or varus (foot) contractures,
Kyphosis, lumbosacral scoliosis, and hip dislocation. Spina Bifida
Occulta- Frequently no observable manifestations. May be associated
with one or more cutaneous manifestations: Skin depression or dimple,
port- wine angiomatous nevi, Dark tufts of hair, and soft, subcutaneous
lipoma. May be neuromuscular disturbances: Progressive disturbances
of gait with foot weakness, bowel/bladder sphincter disturbances.
Downloaded by Denis Professor ()
, 4
What are some considerations regarding care of the patient prior to
myelomeningocele repair? (MEGAN T.R) Myelomeningocele spina
bifida cystica but, has external sac w/ nerve involvement. Keep
newborns prone (avoid laying on the sac), No diapers being born
(friction or pressure kept off sac), antibiotics will be administered, and
sterile moist dressing will be covering the sac. For feedings infant will
have to have head turned to one side since they must be kept prone!
Tube feed could be implemented as well.
(BOOK) Pg # 1022 Care of the myelomeningocele sac, position, and
general care- The infant is usually placed in an incubator or radiant
warmer so that temperature can be maintained without clothing or
covers that might irritate the CNS lesion. When an overhead warmer is
used, the dressing over the defect requires more frequent moistening
because of the dehydrating effect of the radiant heater. Before surgical
closure, the myelomeningocele is kept from drying by the application
of a sterile, moist, non-adherent dressing. The moistening solution is
usually normal saline. Dressings are changed frequently (Every 2 to
4hrs) and the sac is closely inspected for leaks, abrasions, irritation,
and signs of infection. Sometimes the sac ruptures during delivery or
transport, and any opening in the sac greatly increased the risk of
infection to the CNS. Before surgery the infant remains in the prone
position to minimize tension on the sac and the risk of trauma.
Diapering the infant may be contraindicated until the defect has been
repaired and healing is well advanced, or epithelialization has taken
place. The padding beneath the diaper area is changed as need to
keep the skin dry and free of irritation. When the nurse detects
urinary retention, clean intermittent catheterization is used.
What to do for cast care?- Box on Pg # 978. (MEGAN T.R) “Checking
circulation, cast isn’t too tight, and keeping extremity elevated when
they’re sitting/resting.” Checking if cast is too tight= fitting a finger or
Downloaded by Denis Professor ()
NUR 1050 PEDIATRIC NURSING FINAL EXAM
STUDY GUIDE CONDITIONS & CARE 2026 JUST
RELEASED VERSION
What are the 2 kinds of spina bifida and what are signs and symptoms?
(MEGAN T.R )Pg # 1016 Spina bifida is one of the type of myelodysplasia
which is a malformation of the spinal canal in the cord. Spina bifida
is specifically where the bony spine doesn’t close all the way. Two
types of Spina bifida are Spina Bifida Occulta and Spina Bifida
Cystica.
Cystica= Visible External Sac -Two types of cystica which are
meningocele (sac has meninges and spinal fluid), and
myelomeningocele (meninges, spinal fluid, but on top has nerves
encased in it)myelomeningocele serious form of cystica.
Occulta= No external sac that is visible
BOX 30.5 ↓
Downloaded by Denis Professor ()
,2
Clinal manifestations SB Occult- (MEGAN T.R) “A Cutaneous
manifestation along the spine, something seen on the skin on the
spinal column most specifically lower part of spinal column (skin
dimple, port wine angiomatous nevi port wine stain), dark tuffs of
hair, soft subcutaneous lipoma. problems w/ gait. Possible to see
bowel/bladder issues but, not in comparison to cystica.
Downloaded by Denis Professor ()
,3
Clinical manifestations SB Cystica- (MEGAN T.R) “Partial paralysis of the
lower extremities, bowel/bladder issues.”
(BOOK)- Pg # 1014-1023- Abnormalities that derive from the
embryonic neural tube (neural tube defects NTD constitute the largest
group of congenital anomalies with multifactorial inheritance. Normally
the spinal cord and cauda equina are encased in a protective sheath of
bone and meninges FIG. 30.5A. Failure of neural tube closure produces
defects of varying degrees BOX 30.4. They may involve the entire length
of the neural tube or may be restricted to a small area. Two of the
defects, acephaly and Spina Bifida, occur in association with each other
more often than would be expected by chance, suggesting a common
origin. Midline defects involving failure of the osseous (bony) spine to
close are called spina bifida, the most common defect of the CNS. SB is
categorized into two types: SB Occult and SB Cystica. SB Occulta refers
to a defect that is not visible externally. It occurs most commonly in the
lumbosacral area. SB Cystica refers to a visible defect with an external
saclike protrusion. The two major forms of SB cystica are meningocele,
which encases meninges and spinal fluid but no neural elements, and
myelomeningocele or (meningomyelocele) which contains meninges,
spinal fluid, and nerves. BOX 30.5
Clinical manifestations of Spina Bifida- Spina bifida cystica= Sensory
disturbances usually parallel to motor dysfunction.
Below second lumbar vertebra: Flaccid, partial paralysis of lower
extremities. Varying degrees of sensory deficit. Overflow incontinence
with constant dribbling of urine. Lack of bowel control. Rectal prolapse
(sometimes) Below third sacral vertebra: No motor impairment,
bladder and anal sphincter paralysis. Joint deformities (sometimes
produced in utero): Talipes valgus or varus (foot) contractures,
Kyphosis, lumbosacral scoliosis, and hip dislocation. Spina Bifida
Occulta- Frequently no observable manifestations. May be associated
with one or more cutaneous manifestations: Skin depression or dimple,
port- wine angiomatous nevi, Dark tufts of hair, and soft, subcutaneous
lipoma. May be neuromuscular disturbances: Progressive disturbances
of gait with foot weakness, bowel/bladder sphincter disturbances.
Downloaded by Denis Professor ()
, 4
What are some considerations regarding care of the patient prior to
myelomeningocele repair? (MEGAN T.R) Myelomeningocele spina
bifida cystica but, has external sac w/ nerve involvement. Keep
newborns prone (avoid laying on the sac), No diapers being born
(friction or pressure kept off sac), antibiotics will be administered, and
sterile moist dressing will be covering the sac. For feedings infant will
have to have head turned to one side since they must be kept prone!
Tube feed could be implemented as well.
(BOOK) Pg # 1022 Care of the myelomeningocele sac, position, and
general care- The infant is usually placed in an incubator or radiant
warmer so that temperature can be maintained without clothing or
covers that might irritate the CNS lesion. When an overhead warmer is
used, the dressing over the defect requires more frequent moistening
because of the dehydrating effect of the radiant heater. Before surgical
closure, the myelomeningocele is kept from drying by the application
of a sterile, moist, non-adherent dressing. The moistening solution is
usually normal saline. Dressings are changed frequently (Every 2 to
4hrs) and the sac is closely inspected for leaks, abrasions, irritation,
and signs of infection. Sometimes the sac ruptures during delivery or
transport, and any opening in the sac greatly increased the risk of
infection to the CNS. Before surgery the infant remains in the prone
position to minimize tension on the sac and the risk of trauma.
Diapering the infant may be contraindicated until the defect has been
repaired and healing is well advanced, or epithelialization has taken
place. The padding beneath the diaper area is changed as need to
keep the skin dry and free of irritation. When the nurse detects
urinary retention, clean intermittent catheterization is used.
What to do for cast care?- Box on Pg # 978. (MEGAN T.R) “Checking
circulation, cast isn’t too tight, and keeping extremity elevated when
they’re sitting/resting.” Checking if cast is too tight= fitting a finger or
Downloaded by Denis Professor ()
