| Encephalocele Posted: 26 Nov 2010 07:49 PM PST 
Encephalocele, sometimes known by the Latin name cranium bifidum, is a neural tube defect characterized by sac-like protrusions of the brain and the membranes that cover it through openings in the skull. It is a rare birth defect. Types of encephalocele - Meningocele – the bulging portion contains only cerebrospinal fluid and the overlaying membrane
- Encephalomeningocele – brain tissue is present.
Causative Factor - Failure of the neural tube to close completely during fetal development
- Encephaloceles occur rarely, at a rate of one per 5,000 live births worldwide. Ethnic, genetic, and environmental factors, as well as parental age, can all affect the likelihood of encephaloceles. The condition can also occur in families with a family history of spina bifida.
- Although the exact cause is unknown, encephaloceles are caused by failure of the neural tube to close completely during fetal development. Research has indicated that teratogens (substances known to cause birth defects), trypan blue (a stain used to color dead tissues or cells blue), and arsenic may damage the developing fetus and cause encephaloceles.
Symptoms - Neurologic problems
- Hydrocephalus
- Spastic quadriplegia (paralysis of the limbs)
- Microcephaly (an abnormally small head)
- Ataxia (uncoordinated muscle movement)
- Developmental delay
- Vision problems
- Mental and growth retardation
- Seizures.
Process of diagnosing the case Usually encephaloceles are noticeable deformities and are diagnosed immediately after birth, but a small encephalocele in the nasal or forehead region can go undetected. Various physical and mental developmental delays can indicate the presence of encephaloceles. Treatment Surgery is currently the only effective treatment, generally performed during infancy. Occasionally, shunts are placed to drain excess cerebrospinal fluid from the brain. Nursing Considerations - Teach the mothers that the role of Folic Acid is very important in every neural tube defects therefore emphasizing this to pregnant woman and those who are planning to get pregnant is very crucial.
- Encourage them to take foods rich in folic acid.
- An adequate prenatal check-up must be complied to provide proper evaluation of the growth and development of the fetus.
Photo credits: www.folicacid.net Related posts: - Anencephaly
- Alpha-fetoprotein Blood Test
- Neonatal Respiratory Adaptation Processes
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| Anencephaly Posted: 26 Nov 2010 07:43 PM PST 
Anencephaly is the absence of a large part of the brain and the skull. It is also called Aprosencephaly with open cranium. It is one of the most common neural tube defects and occurs early in the development of an unborn baby, usually in the 23rd and 26th day of pregnancy. It happens when the upper part of the neural tube fails to close. Cause: - environmental toxins (such as lead, chromium, mercury, and nickel)
- lack of folic acid intake of the mother.
It is also can be inherited as evidence show that a woman who has had one child with a neural tube defect such as anencephaly has about a 3% risk of having another child with a neural tube defect. Woman who are taking certain medications for epilepsy and women with insulin-dependent diabetes have also a higher risk of having a child with a neural tube defect. It is characterized by absence of the skull, absence of the brain (cerebral hemispheres and cerebellum), facial feature abnormalities, heart defects, blindness, deafness, unconscious, and unable to feel pain. Diagnostic evaluation: - A pregnancy ultrasound may be done to confirm the diagnosis. It may reveal too much fluid in the uterus.
- Other tests includes Amniocentesis (to look for increased levels of alpha-fetoprotein), and Alpha-fetoprotein level (increased levels suggest a neural tube defect).
- pre-pregnancy serum folic acid test may also be done.
Prognosis: The prognosis for this condition is usually poor, in which death usually occurs after a few days. Therefore Proper Prenatal Check is very important and that pregnant mothers should get enough folic acid as according to some research, Folic acid can reduce the chance of neural tube defects by 50 percent. Nursing Considerations: - Encourage compliance to pre-natal check-ups.
- Include in the diet foods that are rich in folic acid (cereal, white bread, cooked okra, juice and etc).
- Have a regular ultrasound check-up.
- Listen to the concerns of the pregnant woman about what she is undergoing.
Photo credits: www.medindia.net Related posts: - Encephalocele
- Alpha-fetoprotein Blood Test
- Drug Study – Folic Acid
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| Principles of Sterility – Principles 6, 7, 8 and 9 Posted: 26 Nov 2010 06:46 PM PST 
Principle Number 6: Edges of anything that encloses sterile contents are considered unsterile - Sterile supplies are packed. In opening sterile packages, the area within 1 inch from the edges is considered unsterile. Supplies are handled by the circulator. The upper portion of the package is flapped away from the self and turns the side under. In doing so, the end of the flaps is secured by the band of the circulator to prevent it from dangling loosely. The other flap is pulled towards the circulator; hence, the contents are exposed yet away from the unsterile hands.
- To open a sterile package, the flaps on peel-open packages should be pulled not torn. The sterile contents should be flipped and lifted upward. The circulator should prevent the sterile contents to slide over the unsterile edges.
- When lifting contents from packages, sterile personnel should lift the object straight up while holding their elbows high.
- In cases where a sterile wrapper is used as a table cover instead of a drape, it should cover the entire table surface. Only the interior surface of the wrapper is considered sterile.
- Sterile bottles when opened cannot be recap without contaminating the pouring edges. Thus, all contents must be used or in cases where there is still a solution left, it should be discarded.
Principle Number 7: Sterile field is set-up just before a surgical procedure - The longer a sterile item is exposed to air and environment, the higher the possibility of contamination.
- The practice of covering a sterile set-up does is not in the best interest of the patient. Sterility cannot be guaranteed by just covering a sterile set-up, unless it is under a constant surveillance.
- Covering and uncovering a table may contaminate the sterile items.
Principle Number 8: Sterile areas are continuously kept in view. - Sterility cannot be guaranteed by just covering a sterile set-up, unless it is under a constant surveillance.
- Sterile persons should face the sterile area.
- While waiting for the patient to come inside the OR, someone must stay in the sterile area to maintain vigilance on the sterile set-up.
- Direct observation ensures sterility.
Principle Number 9: Sterile persons keep well within sterile area. - In draping the patient, sterile persons stay at a safe distance from the operating table to maintain sterility.
- Movements in a sterile area are done by passing with each other back to back at a 360 degree turn.
- When a sterile person passes by an unsterile person or area, he or she should turn back to maintain sterility.
- When sterile persons pass by a sterile field or area, they face towards it.
- To prevent contamination during movements in an area, the sterile person asks the unsterile personnel to step aside.
- Movement inside the sterile area is kept at a minimum to avoid contamination.
- Sterile persons stay inside the sterile field or area.
Related posts: - Principles of Sterility – Principle 3, 4 and 5
- Principles of Sterility – Principles 1 & 2
- PRINCIPLES OF ASEPTIC TECHNIQUE
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