University:
Northwest College
Course:
VN420 | Child Health
Academic year:

2024
Views:

453

Pages:

2
Author:

Yesenia M.

CLEFT LIP AND PALATE- PEDS Most common craniofacial anomaly – occurs 1/700 births worldwide Most comm anomalies associated with cleft lip/palate- heart defects, ear malformations, and GU abnormalities Complications- feeding difficulties, altered dentition, delayed or altered speech development, otitis media Pathophyisiology Occurs early in pregnancy Tissue that forms the lip ordinarily fuses by wk 5-6 and the palate closes between 7-9 wks – if either fails to fuse this = infant born with a cleft Therapeutic management Cleft lip usually repaired sx around 2-3 months Cleft palate usually repaired at 6-9 months Assessment Can involve the lip only or extend up to the nostril Palpate w a gloved finger to discover mild clefts Risk factors: maternal smoking, prenatal infection, advanced maternal age, use of anticonvulsants, steroids, and other meds in early pregnancy Nursing management Prevent injury to facial suture or palate sx site Don’t allow infant to rub the suture line Position supine or side lying May need arm restraints Clean suture line as ordered Lip protective device → Logan bow or a butterfly adhesive – to maintain suture line Avoid putting things in mouth that can disrupt suture line – suction catheter, spoon, straw, pacifier, plastic syringe Prevent vigorous or sustained crying in the infant – administer meds, comfort/distraction measures, rocking, cuddling, anticipate meds Promote adequate nutrition Some babies will need a special cleft lip nipple Burn infant to expel excess air taken in during sucking Risk of aspiration- may need prosthodontic device that prevents breast milk or formula from being aspirated Encourage bonding Encourage parent to hold patient Refer parents to cleft palate foundation