Stephanie Talbot

Atresia

Gastroesophageal reflux/reflux dx

GER= gastric contents leak back into esophagus GERD= symptoms or tissue damage that results from reflux of gastric contents into the esophagus.

Hirschsprung Disease

Logan Bar

CL with/without CP most common craniofacial deformity CL with/without CP more common males, CP females CL more common Native Americans & Asians CL involves external nose, nasal septum, nasal cartilages, maxillary alveolar ridges & dental anomalies CP involves nostril & absence of nasal septal development

Cleft lip

Result incomplete Primary & fusion of structures secondary of primitive oral palatine palates cavity fail to fuse involves external May involve nose, nasal septum, soft/hard palate nasal cartilages, involves nostril maxillary alveolar & absence of ridges & dental nasal septal anomalies development Unilateral or bilateral

Cleft Palate

EO 1.2: Describe the Etiology & Pathophysiology for cleft lip & cleft palate
Etiology
CL with/without CP assoc multifactorial inheritance, environmental factors, family occurrence CP assoc. chromosomal abnormalities, familial occurrence, environmental factors ex. Maternal alcohol, nutrition, smoking & tetragons Drugs cause CL/CP= phenytoin, valproic acid, thalidomide & pesticide digoxin

Pathophysiology once neck & jaws develop, the tongue to move downward palatine processes fusing with each other and the primary plate Any delay in this process results failure plates to fuse

EO 1.2: Describe Diagnostic Evaluation for cleft lip & cleft palate

EO 1.2: Describe Therapeutic Management for cleft lip & cleft palate
1. Surgical Repair:
2. Speech therapy Cleft Lip: 3. Othorthodontist Cleft Lip 1st few mths , r st stage 18mths to align 1 10wk & 10lbs preferred, be free of oral, respiratory or maxillary segments to systemic infection near-normal Staggered suture line (Znd (2-5yrs) to reposition 2 plastymin. scarring & lengthens lip), Steri-strips maxillary segments & or Logans bow used take correct dental cross-bite tension off suture line rd (10-11yrs) correct 3 Cleft Palate @ 12-15mths, most faulty occlusion common 18mths to 4rth(12-18) tx permanent maximize speech production & growth of teeth mid-face 4. Audiologist, otolaryngologist Child should be weaned to cup before repair Insertion pressure equalizing tubes to prevent recurring otitis media

EO 1.2: Describe NSG Management for cleft lip & cleft palate
1. Feed upright 2.Frequent burping 3.Use large holed nipple, press cleft lip together w/ fingers to encourage sucking & strengthen muscles---if unable suck use rubber-tipped syringe & drip formula into side mouth 4.Admin gavage feeding if necessary 5.Finish feeding w/ water to wash palate 6.Provide emotional support to family

EO 1.2: Describe NSG Post op Management for cleft lip & cleft palate
Cleft Lip Repair Cleft Palate Repair
1. Place side lying 2. Have sxn avail but use only in emergency 3. Prevent trauma to suture line Use cups only, no straws, utensils, popsicle sticks, chewing gum Provide soft toys Elbow restraints Water after each feeding to clean Distract by holding and cuddling

-avoid prone position 1. Maintain patent airway 2. Assess colour, amt of swallowing *sign bleeding & swallowing blood 3. Anticipate childs needs to avoid crying 4. Elbow restraints 5. Clean suture line after each feeding w/ saline to remove crusts

EO 1.7: Describe Tracheoesophageal Fistula (TEF)

TEF=An open connection between the trachea & esophagus EA= failure esophagus to develop into a continuous passage

EO 1.7: Describe Etiology & Pathophysiology for infants with Tracheoesophageal Fistula (TEF)

EO 1.7: Describe Clinical Manifestations & Diagnostic Evaluations for

infants with Tracheoesophageal Fistula

(TEF)

1.8. Clinical Manifestations

ES: hx polyhydramnios,

Diagnostic Evaluation

inability pass NG tube, increased drooling & salivation (frothy), immed. Regurg. Undigested milk, intermittent cyanosis & apneic periods TEF: normal swallowing but choking & intermittent cyanosis, distended abdomen, aspiration pneumonia

1. Inability pass NG tube 2.Maternal hx polyhydramnios 3.Fluoroscopy w/ contrast material to I.D type defect 4.Chest x-rayshows air stomach