Term
| What are some signs and symptoms of interference with nutrition? |
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Definition
Pain Poor Skin Turgor / Dehydration Brittle nails and bones dull and dry hair infection -- decreased immunity bc of lack of antibodies (made of proteins) anemia poor concentration alteration in weight |
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Term
| What is a cleft lip and palate? |
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Definition
| Abnormal opening in lip, palate, and sometimes naval cavity. |
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Term
| What are some factors that influence the development of cleft palate? |
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Definition
| Environmental and genetic. |
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Term
| When does cleft lip and cleft palate occur in fetal development? |
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Definition
Cleft lip -- 6th to 8th week Cleft palate -- 7th to 12th week |
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Term
| What are some outcomes of a child born with cleft lip and cleft palate? |
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Definition
inadequate nutrition poor skin turgor growth and development delays |
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Term
| How does cleft lip occur? |
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Definition
| Maxillary and median nasal process fail to fuse. |
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Term
| What are the different kinds of cleft lip? |
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Definition
| Unilateral, bilateral, or complete |
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Term
| What are some issues that a family with cleft lip faces? |
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Definition
Emotional issues Mouth breathing Difficult sucking Deformed dental structures |
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Term
| What goes wrong in fetal development to create a cleft palate? |
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Definition
| Failture of midline fissure to close properly |
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Term
| What is the surgical procedure to close a cleft lip? Cleft palate? |
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Definition
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Term
| How is cleft lip/cleft palate therapeautically managed? |
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Definition
| Modified feedings, special feeding techniques, frequnt burping |
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Term
What is cleft palate surgery performed? Cleft lip? |
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Definition
| 6-24 months (12-18 months), 3-6 months, repair 4-5 years |
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Term
| What are some long term problems kids with cleft lip or palate may face? |
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Definition
speech issues ear infections/scarred tubing dental and emotional issues |
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Term
| In what positions should children with cleft lip or palate be fed? |
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Definition
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Term
| What is the ESSR feeding method for feeding a child with cleft lip or palate? |
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Definition
E - enlarge nipple S - stimulate, with nipple at cheek S - swallow small amount, slowly R - rest and burp be aware of excessive air |
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Term
| What are homecare guidelines for a child who has undergone surgery for cleft lip or palate? |
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Definition
Elbow restraints - not tight, removed every 2 hours for 10-15 minutes, removed 1 at a time, observe for skin irritation, always be with child when removed Do not brush teeth for 1-2 weeks Give water after meals Side or backlying position only |
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Term
| What are therapeutic nursing interventions for a child with cleft lip or palate? |
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Definition
Teach parents ESSR method Assess caloric intake Ensure child is in a semi sitting position Support parents encourage parents to hold and bond with baby right away |
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Term
| What is a tracheospohageal fistula? |
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Definition
Hole b/t esophogus and trachea esophogus often ends in a pouch w/o reaching stomach |
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Term
| What are the three C's of TEF? |
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Definition
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Term
| When does TEF develop in the fetus? |
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Definition
| 4th or 5th week of fetal development |
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Term
| What is the incidence of TEF? |
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Definition
1:2000-4500 30% premature male = female often present with other congenital defects |
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Term
| What are the manifestations of TEF? |
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Definition
excessive salivation and drooling coughing, choking, regurgitation cyanosis abdominal distenstion risk of aspiration pnemonia |
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Term
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Definition
suspected if NG tube cannot pass 10-11 cm beyond gum line confirmed with abdominal XRay |
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Term
| What is therapeautic management of TEF? |
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Definition
measure abdominal growth continuouse or intermitten suction medicate for pain keep infant supine with head elevated to decrease chance of gastric secretions entering lungs IV fluids essential -- NPO assess resp status, choking, excessive secretions, cyanosis |
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Term
| What is the surgery for TEF? |
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Definition
tie off fistula insert G-tube anistimosis |
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Term
| What should be monitored post surgically in a child with TEF? |
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Definition
infection (antibiotics as ordered) motility dysfunction gastroesphogeal reflux |
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Term
| Why is a pacifier extremely important for a baby with TEF? |
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Definition
sucking reflex allows them to transition to regular eating after surgery |
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Term
| What are some home care teachings for parents with child with TEF? |
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Definition
care of gastronomy site until esophogus is healed keeping baby hydrated administration of antibiotics - watch for clogging assessment criteria for skin and or respirations, skin intact, etc |
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Term
| What might the family of an anorexic/bulemic teen be like? |
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Definition
Anorexia - controlling Bulemia - chaotic usually family hx of affective disorder |
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Term
| What are the clinical manifestations of anorexia? |
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Definition
preoccupation with food extreme weight loss intense fear of becoming fat body image disturbance weight decreased by 25% dizziness, constipation, abdominal distenstion irregular menses, ameorreah malnutrition hypothalmic suppression fluid and electrolyte imblance cardiac arrythmias excessive exercise 4x per day abuse of laxatives |
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Term
| What are the clinical manifestations of bulemia? |
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Definition
erosion of tooth enamel dental caries / gum recession electrolyte disturbances abdominal distension esophageal tears and esophagitis recurrent binge eating awareness of abnormal eating fear of not being able to stop eating happy when eating, depressed after binge laxative purging |
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Term
| How is anorexia nervosa or bulemia diagnosed? |
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Definition
lab studies -- CBC, infection, liver studies, electrolytes renal and thyroid studies EKG CXR |
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Term
| How is anorexia or bulemia initially treated? |
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Definition
Focus on secondary effects of vomiting, diuretics/laxatives, and insufficient nutrients. Electrolytes and body chemistry stabalized to prevent damage to lungs, heart, and GI system |
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Term
| What type of therapy do pts with anorexia or bulemia undergo? |
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Definition
individualized, intensive, to help adolescents cope with complex issues of body image and misperceptions, issues of control and self managment f/u for pt and family for several month to three years |
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Term
| What are some nursing diagnoses for a child or adolescent with a eating disorder? |
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Definition
altered nutrition: less than body requirement r/t inadequate intake or malabsorption anxiety, fear, powerlessness r/t weight gain, sense of inadequecy, lack of control over body or self image disturbance deficient fluid volume r/t excessive use of diuretics/laxatives and or inadequate fiber and fluid intake |
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Term
| What are some therapeutic nursing interventions for a diagnoses related to anorexia or bulemia? What are some evaluations? |
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Definition
Interventions: encourage eating, observe eating behaviors, administer meds as need Evaluations: weight gain, normal bowel function, development of positive self image |
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