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