Focus on Maternity Practice Exam

The most important preoperative action is to protect the exposed sac from injury. The sac that comes with a myelomeningocele is fragile and its integrity is critical because rupture or damage can introduce bacteria and lead to meningitis or worsen neurological outcomes. To minimize this risk, keep the infant in a position that reduces pressure and friction on the sac, cover the sac with sterile, moist dressings, handle the infant gently, and maintain strict cleanliness with dressing changes. Diapering should avoid rubbing the sac, and overall care aims to keep the sac protected until surgical repair.

While feeding and baths are important aspects of newborn care, they do not address the immediate threat to the neural tissue as directly as protecting the sac does. Placing the infant in a supine position could put pressure on the sac, which is not ideal before surgery.