Page 1093 - Saunders Comprehensive Review For NCLEX-RN

that repair the affected organs, muscles, and bones.
6. Initial surgery for closure of the abdominal defect
should occur within the first few days of life.
7. The goal of subsequent surgeries is to reconstruct the
bladder and genitalia and enable the child to achieve
urinary continence.
B. Assessment
1. Exposed bladder mucosa and epispadius in males
2. Defects of the abdominal wall
3. Vesicoureteral reflux
4. Defects of the rectum and anus
C. Interventions
1. Monitor urinary output.
2. Monitor for signs of urinary tract or wound infection.
3. Maintain the integrity of the exposed bladder mucosa.

4. Prevent the bladder tissue from drying, while

allowing the drainage of urine, until surgical closure
is performed. Immediately after birth, as prescribed,
the exposed bladder is covered with a sterile,
nonadherent dressing to protect it until closure can be
performed.
5. Monitor laboratory values and urinalysis to assess
renal function.
6. Administer antibiotics as prescribed.
7. Provide emotional support to the parents, and
encourage verbalization of their fears and concerns.

Applying petroleum jelly to the bladder mucosa is avoided

because it tends to dry out, adhere to the bladder mucosa, and damage
the delicate tissues when the dressing is removed.
IX. Sexually Transmitted Infections (STIs)
A. Screening for certain STIs should be done for certain children and
adolescents. See
http://pediatrics.aappublications.org/content/early/2014/06/25/peds.2014-
1024 for specific recommendations.
B. Refer to Chapters 21 and 22 for more detailed information on STIs.

Box 37-1
Assessment Findings in Glomerulonephritis

▪ Periorbital and facial edema that is more prominent in the morning
▪ Anorexia

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