Abnormal Development (Fall 22')

What is the surgical intervention for cleft lip

lip repair at 2-3 mos of age

trisomy 21 (down syndrome) is

genetic disorder defined by a presence of all or part of an extra 21st chromosome

post-op care for cleft lip/palate

-observe airway for obstruction/bleeding -prevent injury to suture line -position supine and upright or side-lying -facilitation of drainage -facemask for O2 if needed -cleansing suture line -keep infant calm -avoid items in mouth

Nursing interventions for Cerebral Palsy

-promote mobility -fam/pt support and education -maintain optimal nutrition intake -interdisciplinary team (PT, OT, speech) -surgical interventions -orthotics or braces

nutrition for trisomy 21

-risk for weight gain/ obesity -faster wt. than height growth -difficulty sucking due to hypotonia -need high fiber d/t decreased gastric motility bc of hypotonia -encourage activity

interventions for people with autism spectrum disorder

-structured school environment -occupational, physical, and speech therapy -cognitive behavior therapy -relationship development intervention -applied behavior analysis -complimentary/alternative behaviors

nutrition for cleft lip/palate

-breastfeed -utilize feeding devices (to help baby suck) (squeeze bottle) -frequent burping (bc air gets thru from cleft lip) -sit upright after feeds

what are some symptoms of autism?

-failure to point at objects -mute or utter sounds; repeats phrases over and over -spends hours in repetitive activity -bizarre motor behaviors (hand flapping) -resists cuddling -avoids eye contact

What are down syndrome ppl at risk for

congenital heart defects visual/hearing impairments thyroid disease leukemia/anemia/polycythemia obstructive sleep apnea alopecia seizures

What is failure to thrive?

A child fails to demonstrate appropriate weight gain over a prolonged period.

Cerebral palsy

Abnormal motor development caused by nonprogressive abnormal brain function. or Abnormal development or damage to motor areas of the brain

A child with spastic cerebral palsy is to receive botulin toxin. Which treatment goals should the healthcare team set for the child related to botulinum toxin? SATA A. improved nutrition B. decreased pain from spasticity C. Improved motor function D. enhanced self-esteem E. reduced care-giver strain and improved self care F. decr speech impediment

B, C, D, E

Which statement by a parent would indicate a potential autism diagnosis? SATA a. mild child uses their finger to point at something b. my child smiles back at me, when I smile at him c. my child makes finger movements near her eyes d. my child gets upset and screams when I run the vacuum cleaner e. sometimes I wonder if my child cannot hear me

C, D, E

baclofen is a

Muscle Relaxant decreases muscle spasms and spasticity

types of cerebral palsy

Spastic, Dyskinetic/Athetoid, Ataxic, Mixed

what is a developmental delay

a lag in meeting developmental milestones

Mixed Cerebral Palsy

any combo of all types of cerebral palsy

Pharm management for cerebral palsy:

baclofen diazepam glycopyrrolate botulinum toxin A

what is autism

developmental disability caused by differences in the brain affecting a child ability to form relationships, communicate, learn, and behave

Nutrition in children with cerebral palsy

difficult eating/swallowing d/t poor control of mouth/throat -may require longer eating times -special diets: pureed or soft for easy swallow -proper position to reduce aspiration -If severe swallow impair then may need feeding tube

complications that come with cleft lip/palate

difficult feeding altered dentition delayed speech development otitis media

Dysarthria

difficulty forming words/ slurred speech

Glycopyrrolate is used for

dries up secretions bc its a anticholinergic

After talking with the parents of a child with down syndrome, the nurse should help the parents establish which goal? -encourage self-care skills in the child -teach the child something new each day -encourage more lenient behavior limits for the child -achieve age-approp social skills

encourage self care skills in the child

Spasticity

increased muscle tone making them stiff and hard to move

what is the M-CHAT-R for?

its a psychological questionnaire that evaluates risk for autism in toddlers

what is an important nursing consideration post-op after a cleft lip/palate repair? -admin analgesics such as tylenol -maintain patent airway -feeding -suctioning mouth

maintain patent airway

Organic causes of FTT

mental/physical impairment cerebral palsy, cardiac defects malabsorption diarrhea vomiting changes in metabolism bc of chronic illness

What meds are used to control hyperactivity in children with autism?

mixed amphetamine salts (MAS) methylphenidate

Nursing interventions for cleft life/palate

monitor wt. (bc of eating troubles) aspiration precautions (trouble swallowing) encourage parent-infant bonding (parent could be in denial)

Cleft lip/palate is?

most common congenital anomaly -associated with other disorders -50% of children who have cleft lip also have cleft palate

who has the highest risk for having a down syndrome baby

mothers >35

nonorganic causes of FTT

neglect abuse behavioral problems lack of maternal interaction poor feeding techniques lack of parental knowledge poverty

Interventions for FTT

observe parent-child interaction weigh child daily provide support if child cant grow properly structured routine interdisciplinary team remain persistent

what is the surgical intervention for cleft palate

palate repair at 6-7 mos

Ataxic Cerebral Palsy

poor coordination/balance poor control of upper extremities unsteady gait language/motor skills delayed

causes of cerebral palsy

prenatal: hypoxia, environment toxins, pre-eclampsia, genetic abnormalities, multiples Perinatal: prematurity, hypoxia, asphyxia, sepsis, placental complications, chorioamnionitis, cerebral hemorrhage Postnatal: seizures, viral/bac infx, hemorrhage, kernicterus, asphyxia

Interventions for Trisomy 21

provide supportive measures for growth and development -prevent complications (vaxed, cardiac app, hearing/vision) -provide support and education to family and child

Botulinum toxin A

reduces spasticity in specific muscles *helps with ROM*

Diazepam is used for what in cerebral palsy pts

relaxes muscles

what meds are used to help manage repetitive and aggressive behaviors in children with autism?

risperidone aripiprazole

what are characteristics of down syndrome?

slanted eyes depressed nasal bridge hypotonia (no muscle tone) short protrusion of tongue excessive skin on back of neck

dyskinetic/athetoid cerebral palsy

slow uncontrolled movement of the upper and lower extremities. drooling or hyperactive tongue movement is seen, difficult time communicating and uncoordinated walking

asphyxia

smothering, suffocation

How does nutrition look for a child with autism?

they may have preference for specific textures, colors, and smells of food or even the environment where they eat.

T or F Asperger syndrome is a part of autism?

true

T or F cerebral palsy is non progressive

true

T or F children need adequate nutrition in the first 2 yrs of life for approp. brain growth

true

T or F children with autism may eat a narrower range of food

true

T or F life expectancy of down syndrome person is around 60

true

T or F the tissue for the lip fuses in early pregnancy (5-6 weeks) and palate closes early at (7-9 weeks)

true

Spastic Cerebral Palsy (most common)

very tight muscles occurring in one or more muscle groups, resulting in STIFF, uncoordinated movements

The healthcare team determines that the fam with an infant with FTT who is to be discharged will need follow-up care. Which approach would be the most effective? -daily phone calls -enrollment in community parenting classes -twice weekly clinic app -weekly visits by community nurse

weekly visits by community nurse