A nurse is providing discharge teaching to the guardian of an infant who had a large myelomeningocele repair in the lumbar area. Which of the following instructions should the nurse include?

Discharge teaching for myelomeningocele repair focuses on long-term complication prevention and neurogenic bladder or bowel management. The nurse must prioritize environmental safety, specifically related to the high prevalence of latex sensitivities and potential autonomic or motor impairments in these children. Choice A rationale Clean intermittent catheterization is often required for neurogenic bladders, but the frequency is typically every 4 to 6 hours. An 8-hour interval is generally too long and increases the risk of urinary stasis, infection, and bladder distention. Choice B rationale Children with spina bifida have a significantly high risk for developing life-threatening latex allergies due to frequent medical exposures. Guardians must strictly avoid latex in household items, toys, and pacifiers to prevent anaphylaxis or hypersensitivity reactions. Choice C rationale The goal of surgical repair and ongoing management is to preserve existing neurological function rather than anticipating gradual loss. While some deficits are permanent, progressive decline is not a standard expectation and could indicate complications like tethered cord. Choice D rationale Rectal thermometers or interventions should be avoided due to the risk of rectal prolapse or injury in children with impaired anal sphincter tone. Bowel programs usually focus on diet, hydration, and safe stool softeners to manage neurogenic bowel.