An infant has just undergone surgical repair of a myelomeningocele. What is the priority nursing intervention to perform immediately following the procedure?

Choice A rationale Monitoring intake and output is crucial post-operatively to assess fluid balance and renal function. However, the immediate priority after myelomeningocele repair is preventing infection and protecting the surgical site, as this directly impacts neurological integrity and overall survival. Fluid balance is a secondary, albeit important, consideration. Choice B rationale Monitoring head circumference is important to detect hydrocephalus, a common complication of myelomeningocele. While essential for long-term neurological assessment, protecting the fresh surgical repair from contamination and mechanical stress takes immediate precedence to prevent life-threatening infections and CSF leakage. Choice C rationale Positioning the infant supine immediately after myelomeningocele repair is the priority intervention. This position protects the delicate surgical incision from pressure, contamination, and potential rupture, reducing the risk of infection, cerebrospinal fluid (CSF) leakage, and subsequent neurological damage, which are critical complications. Choice D rationale Maintaining skin integrity around the surgical site is vital to prevent infection and promote healing. This involves meticulous wound care and frequent assessment. However, the *initial* and most critical intervention directly after surgery is to protect the site from any external pressure or contamination by appropriate positioning.