Spina Bifida

30.10.2020 in Research Paper
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The Teaching Plan

The assessment elements of the learner: structured interview questions, the learners self assessment, and simple notes made by the teacher during the observation of learners

An expected learner needs: the information about prevention of spina bifida, its signs and symptoms, the development of the disorder, the process of infection, treatment; the national statistics and the frequently asked questions

Teaching strategies: Provide information, directly giving all key facts about spina bifida; ask questions that encourage the learners thinking

Resources used to improve learning: spina bifida fact sheet (with images)

Evaluation methods: questionnaire

Rationales: Assessing the learners needs to be objective and informative, and using three assessment elements to help them achieve these objectives ( Riley, 2014, p. 63). The leaner must raise awareness about spina bifida, so that the list of expected learning needs includes essential components of the disorder. Using such teaching strategies as providing information and asking questions will help to provide all necessary information in a short time. Spina difida fact sheets with images will enhance communication of health risks and help students memorize the data effectively (Garcia-Retamero & Cokely, 2013, p. 392). Learning outcomes will be checked through questionnaires, because the student will have to learn a significant amount of information, and a questionnaire is effective in evaluating a wide quantity of content (Grohmann, A., & Kauffeld, 2013, p. 135). Besides, the questionnaire helps to review the content again, which is necessary for this teaching project.

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The Discussion about Spina Bifida

Prevention. Folic acid significantly decreases the risk of developing spina bibida. Parents need to start taking this acid once a month prior to conception and during the first trimester of pregnancy. However, many female patients do not plan their pregnancies. Therefore, it is reasonable to recommend all individuals of childbearing age to consume 400 micrograms of the supplement every day (Centers for Disease Prevention and Control, 2016). Patients can obtain folic acid by eating bread, pasta, cereal, beans, citrus fruits, broccoli, spinach, egg yolks, and rice. They can also take vitamin supplements. Women with diabetes or taking anti-seizure drugs should consume higher doses of folic acid. Females with obesity need to take control of their weight before pregnancy. It is also necessary to avoid body overheating and use Tylenol for curing fevers.

Signs and Symptoms. There are three forms of spina bifida, and they have various signs and symptoms (see Fig.1). Spina bifida occulta is a tiny separation in bones of the space, which does not affect spinal nerves. Patients with this type of disease do not have any signs or symptoms. Only some newborns have fat, hair, or a birthmark above the spinal defect on their body (Centers for Disease Prevention and Control, 2016). In the case of meningocele, some fluid comes from the patients back. The spinal cord is not in sac of fluid and the nerve is not damaged. Patients with meningocele might have small disabilities. The most serious form of spina bifida is myelomeningocele. In this case, the patients spinal canal is open along several bones in the lower and middle back, which leads to the forming of a sac. Normally, tissues and nerves are not covered. The typical neurological damages are muscle weaknesses of limbs, bowel or bladder issues, orthopedic issues, and seizures.

Forms of spina bifida

Figure 1. Forms of spina bifida (Centers for Disease Prevention and Control, 2016)

Frequently Asked Questions. Learning about spina bifida: What is spina bifida? How much folic acid do I have to take before and during pregnancy? Testing for the disease: What do I have to know about testing for spina bifida? Obtaining treatment: What is physical therapy? What is occupational therapy? Living with the disease: How can I help my child to develop proper self-esteem? What is latex allergy? How should I take care of myself/my child?

How it develops. Nobody knows the exact cause of developing spina bifida; it is also unknown why the neutral tube does not close completely leading to malformation. The researchers believe that the disorder could be caused by a variety of factors, including genetic, nutritional, and environmental aspects (National Institute of Neurological Disorders and Stroke, 2015). However, the key factor is the lack of folic acid in the mothers diet.

Process of Infection. Apart from physical and neurological issues,spina bifida can also cause infection. In particular, the infection develops in the tissues near the brain. The infection is called meningitis. It may lead to brain injury and death. The process of infection is common among children with myelomeningocele. Besides, babies with spina bifida are likely to develop urinary tract infections (UTIs) (Centers for Disease Prevention and Control, 2016). UTIs occurs when the bacteria appear in the urinary tract.

The National Statistics. In the United States, 1,500 individuals are born with spina bifida annually (Centers for Disease Prevention and Control, 2016). However, the quantity of cases reported has begun to decline (see Fig.2). The positive trend was caused by two factors. The first factor is the U.S. Public Health Services recommendation to take 400 micrograms of folic acid every day. The second factor is the requirement of the U.S. Food and Drug Administration to add folic acid to all grain products. Hispanic women are at a greater risk of having babies with the disease than white or black women. Thus, the prevalence of spina bifida among Hispanic people is 3.80 per 10,000 live births, while the prevalence of spina bifida among African Americans and Caucasians is 2.73 and 3.09 respectively (Centers for Disease Prevention and Control, 2016). Therefore, Hispanic women should pay particular attention to consuming folic acid.

Trends in spina bifida

Figure 2. Trends in spina bifida (Centers for Disease Prevention and Control, 2016)

Treatment. Researchers have not developed a cure for this disease. It is still impossible to repair the damaged nerves. However, people with spina bifida do need some treatments to avoid complications. The treatment depends of the type of the disorder and the age of a patient. Children with spina bifida occulta do not normally need any treatment early on, but require certain types of surgeries when they get older. As for treating more serious forms of the disorder, the main priority is avoiding infection due to uncovered nerves and tissue. Besides, healthcare providers should protect the exposed parts from further damage. Health professionals reach these goals through surgery in the first few days after a babys birth (National Institute of Neurological Disorders and Stroke, 2015). During the surgery, specialists close the spinal defect and minimize the risks discussed above.

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Besides, some medical centers perform surgery of fetuses. Although this approach cannot restore damaged neurological functions, it can help avoid additional complications. However, such surgery is risky for both the mother and her future baby. The main risk for the fetus is premature delivery. The mother can face infection and blood loss. Nevertheless, the benefits of the surgery are impressive, so some mothers agree to have the surgery.

Additionally, 20-50% babies with the myelomeningocele require surgery on the tethered spinal cord (National Institute of Neurological Disorders and Stroke, 2015). Ignoring this treatment can lead to the stretching of the spinal cord with time. As a result, the child could have the paralysis of legs, and bowel and bladder problems. In addition, some patients might need surgeries to address the issues with their feet, spine, or hips. Many children also need some assistive devices, such as wheelchairs and walkers. Starting an exercise routine in the early age can reduce the risks of paralysis.

In conclusion, there is no cure for spina bifida. Therefore, both healthcare providers and mothers have to focus on preventing the disorder. Today, taking folic acid is the key prevention method. In the U.S., spina bifida is more common among Hispanic women, so they should pay special attention to their diet. Depending on the form of the disorder, patients might need some surgeries and assistive gadgets.

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