Postoperative care for an infant who had a myelomeningocele repair should include which measurement?

• A. Securely fastening the diaper
• B. Measurement of pupil size
• C. Administration of seizure medications
• D. Head circumference measurement

Answer: (D)

After repairing a myelomeningocele, watching for signs of hydrocephalus is a priority because ventricles can enlarge and raise intracranial pressure. The best way to do this in an infant is to monitor head circumference over time. Serial head measurements reflect changes in ventricular size and brain growth, and a rising head circumference can prompt early imaging and intervention if hydrocephalus is developing. Keeping track of this metric helps ensure timely decisions about further treatment.

Other options don’t directly track brain ventricle status. Measuring pupil size is part of neuro checks but doesn’t quantify changes in ventricular size. Securely fastening a diaper is routine care unrelated to brain status, and giving seizure medications isn’t a standard postoperative requirement unless there’s a specific seizure history.