Abnormal development
Surgery for lip repair at
2-3 mo
Tissue for lip closes at
5-6 wks gest.
Surgery for palate repair at
6-7 mo
Palate closes at
7-9 wks gest.
Dyskinetic/Athetoid CP
Abnormal involuntary movements Limp, all 4 extremities face,neck,tongue affected
Cerebral palsy
Abnormal motor pattern/postures caused by non progressive abnormal brain function,and results in a neurologic lesion
Ataxic CP
Affects balance and depth perception
Mixed CP
Any combo of all types
Nutrition for kids w autism
Are picky Prefer diff textures, temps, colors, and smells of foods May not like to eat w everyone else
Meds for CP
Baclofen-muscle relaxant Diazepam-benzo and is a muscle relaxant Glycopyrrolate-anticholinergic-drys things up Botulinum toxin A-Botox-reduces spasticity usually in lower body to help move
Pervasive autism
Behavioral issues
Nutrition for cleft
Breast feed still ok Use feeding devices as needed Assess suck and feeding Burp a lot bc take in more air Air up after feedings May use one way valve devices
Goal for kids w FTT
Child to ingest/receive calories enough to increase growth
Ppl w downs are at risk for
Congenital heart defects Visual and hearing deficits Thyroid disease Leukemia,anemia,polycythemia Obstructive sleep apnea Infections-upper respiratory and ear Alopecia Seizures Life expectancy is 60 years
Stimulants are to
Control hyperactivity
A child w spastic CP is to begin botulinum toxin type A injections.which treatment goals should the healthcare team set for the child related to botulinum toxin
Decreased pain from spasticity Improved motor function Enhanced self esteem Reduced caregiver strain and improved self care
develop for kids w FTT
Develop feeding schedule
Autism Spectrum Disorder
Developmental disability caused by differences in the brain Social interaction probs speaking issues cognitive issues Cause unknown Autistic syndrome Asperger syndrome
Characteristics of autism
Differences in behavior,communication,and learning Typically diagnosed b/t 12-36 Failure to point at things Mute or utter sounds;repeat phrases over and over Spends house in repetitive activity Weird motor behaviors(hand flapping) Resist cuddles Avoid eye contact
Nutrition w kids w CP
Difficulty eating and swallowing due to lack of motor control Longer eating time Special diets-puréed or soft Proper position to reduce risk for aspiration May need feeding tube
Complications w cleft
Difficulty feeding Altered dental Delayed speech development Otitis media
After talking w the parents of a child w Down syndrome, the nurse should help parents establish which goal?
Encourage self care skills in the child
Trisomy 21 (Down Syndrome)
Genetic disorder defined by presence of all or part of an extra 21st chromosome Can see it in all races and socioeconomic levels High risk for old moms 35 plus
Things that affect growth and development
Genetics Smoking Premature Toxins Overweight Maternal choices Environmental factors Lack of care
Prenatal causes of CP
Hypoxia,environmental toxins,pre-eclampsia,genetic abnormalities,multiples
Downs can be diagnosed when
In utero
Failure to Thrive (FTT)
Inadequate GROWTH in infants and children No appropriate weight gain over prolonged period
Characteristics of downs
Intellectual disability Slanted eyes Depressed nasal bridge Hypotonia(flaccid) Short Small mouth A lot of skin on neck A lot of space between big toe and second one
Nursing interventions for kids w autism
Kids are unique Assessments and accurate histories are important Treatments: Structured school environment (IEP) Occupational,physical,and speech therapy Cognitive behavioral therapy (CBT) Relationship development intervention(RDI) Applied behavioral analysis (ABA) Complentary/ alternative behaviors
Asperger's Syndrome
Low severity High function High IQ
What is an important nursing consideration post op after cleft lip/palate repair
Maintain patent airway
Maintain for kids w FTT
Maintain strict intake and output records
antipsychotic drugs are to
Manage repetitive and aggressive behaviors
Stimulants
Mixed amphetamine salts(MAS) Methylphenidate
M-CHAT-R
Modified Checklist for Autism in Toddlers, Revised Parents answer a bunch of questions Usually done b/t 1 year and 18 mo
Nursing interventions for cleft
Monitor weight Aspiration precautions Bind w infant and parent
Which statement by a parent would indicate a potential autism diagnosis
My child makes finger move to near her eyes My child gets upset and screams when I run the vacuum Sometimes I wonder if my child can hear me
Nonorganic FTT
Neglect Abuse Behavioral problems Lack of maternal interaction Poor feeding techniques Lack of parental knowledge Poverty
Post op care for cleft
Observe for airway obstruction or bleeding Prevent injury to suture line Position supine and upright or side lying Collect drainage O2 if need Clean it Keep indent calm Avoid items in mouth
Nursing interventions for FTT
Observe kid and parent together Weigh kid daily Provide support Routines Interdisciplinary team Remain persistent
Organic FTT
Occurs when there is an underlying medical cause Mental or physical impairment Cerebral palsy,cardiac defects,malabsorption,diarrhea,vomiting,changes in metabolism, caloric needs related to chronic illness
Perinatal causes of CP
Prematurity (less than 37 weeks gestation) Hypoxia Asphyxia Sepsis Placental complications Chorioamnionitis( infection of outer layer and amniotic fluid of placenta) Cerebral hemorrhage
Nursing interventions for CP
Promote mobility Support fam and educate Orthotics or braces Maintain nutrition Interdisciplinary team(PT, OT, speech) Surgery(can lengthen tendons)
Nursing interventions for downs
Provide support to promote growth and development Prevent complications Educate
Nutrition for downs
Risk for weight gain and obesity Faster weight and height growth(lower basal metabolic rates) Difficulty sucking bc decreased muscle tone High fiber due to decreased gastric motility for lack of muscle tone Encourage activities
Postnatal causes of CP
Seizures, viral/bacterial infection,intraventricular hemorrhage,kernicterus(increased bili),asphyxia
Kanners/ classical autism
Severe Low IQ
What is the most common type of CP
Spastic
Educate for FTT
Teach parents proper feeding techniques and amts
The healthcare team determines that the family of an infant with FTT who is to be discharged will need follow up care. Which approach is most effective for follow up?
Weekly visits by a community health nurse
Spastic CP
hypertonicity(stiff) Permanent contractures
Developmental delay
lag in meeting developmental milestones Playing, learning,speaking,behaving, moving
developmental disability
mental or physical or combination impairment resulting in lifelong disability,that may contribute to failure to thrive
Cleft lip/palate
most common congenital craniofacial anomaly 50% of kids that have cleft lip also have palate Can be unilateral( typically left side) or bilateral
Antipsychotics
risperidone Aripiprazole