T2-GI Disorders: Cleft Lip/Palate Flashcards
Cleft lip with or without Cleft palate is more common in males or females?
Males
Cleft palate alone is more common in males or females?
Females
Is cleft lip/palate familial?
Yes
Cleft lip/palate is familial, can occur with associated defects with other _____ abnormalities, or environmental _____
With other chromosomal abnormalities or environmental teratogens
Cleft lip is a failure of the ____ & _____ processes to fuse
Maxillary and median nasal processes
The merging of the upper lip at midline is complete by ____
7-8 weeks gestation
When does cleft palate appear?
When there is failure of the palatal shelves to fuse
When do the palatal shelves fuse?
7-12 weeks gestation; tongue has to get out of the way in order for palates to fuse
Can you have cleft lip without cleft palate?
Yes
Can you have cleft palate without cleft lip?
Yes
Can you have both cleft palate and lip together?
Yes
Which is this: Cleft palate or lip
Involves soft palate, hard, palate or both
Cleft palate
Cleft lip is only unilateral. T/F?
FALSE; it can be unilateral or bilateral
If unilateral, under a nostril may be a ___ in lip or go all the way up into the floor of the nose.
Notch
What else is going on in the first trimester?
N/V, so some docs don’t give prenatal vitamins or pt. may not be getting full benefit of taking vitamins
What can help prevent cleft?
Folic acid
____ defects affected by folic acid
Midline
What is the goal for cleft lip/palate?
- Closure of the clients
- Prevention of complications
- Facilitation of normal growth and development
Is it better to breast or bottle feed a baby?
Breast; the breast will conform better to odd shape of the lips
What is the surgical correction for cleft lip?
Z-plasty
Z-plasty is for the correction of cleft lip. When is this procedure usually done?
6-12 weeks of age in healthy infant
How is cleft palate surgically fixed?
Palatoplasty
Palatoplasy is the procedure for the correction of cleft palate. When is this usually done?
12-18 months; repaired right before development of speech
What is harder to repair: cleft lip or cleft palate?
Cleft palate–nothing to work with, so as they grow, the cleft in the palate will get smaller (if wait too long, its hard to repair)
What is the post-operative care for cleft lip goal?
Protection of surgical site
What are the 5 ways to achieve the goal of “protection of surgical site” for a post-operative care for cleft lip?
- Never position on stomach
- Elbow restraints
- Oral and wound care
- Comfort measures/pain control
- Logan’s bar or steri strips
Used to hold and protect suture line
Logan’s bar or steri strips
Cleft lip: Post op
What are immediate nursing problems?
Bleeding
Infant upset
Nose breathers (so won’t be able to breathe through nose–inflammation)
Cleft palate post op:
- ____ restraints
- Issues with ____ because of where suture line is
- Frequent swallowing= sign of ____
- Sucking pacifers or straws allowed?
- Avoid what till healed?
- Elbow restraints
- Issues with AIRWAY
- Sign of BLEEDING
- Sucking pacifers or straws= NO
- Avoid UTENSILS till healed
Cleft palate post op:
Progress diet to?
Slenderized food with progression to soft diet
Cleft palate: Post op?
How do they drink?
Cup
Cleft palate: Post op
What are some complications?
- Middle ear infections
- Nasopharyngeal infections
- Sinus infections
- Associated hearing loss
- Speech delay
What is the long term cleft palate/cleft lip goal?
Enhance or maintain a positive self-image
Who else may be involved with cleft palate/cleft lip?
Speech therapy
Orthodontist
What are some psychosocial issues for parents of cleft lip/cleft palate children?
- Trouble bonding with child
- Grieft
- Realizing child is not perfect
- Financial support
- Teaching them physical care of infant
- Routine health maintained
- Seek med care early in illness
- Concerns over speech
