ACTIVE LEARNING TEMPLATE: System Disorder
Saria Merriweather
STUDENT NAME______________________________________
Cleft Lip/Cleft Palate
DISORDER/DISEASE PROCESS___________________________________________________________ REVIEW MODULE CHAPTER__23
Alterations in
Health (Diagnosis)
Ineffective airway clearance r/t
aspiration of feedings
Imbalanced nutrition: less than body
requirements r/t inability to ingest
food
ASSESSMENT
Risk Factors
Other syndromes, combination of
maternal and environmental factors,
family hx of CL/CP, exposure to alcohol,
cigarette smoke, anticonvulsants,
retinoids, steroids during preg, folate def
during preg
Laboratory Tests
Ultrasounds, pulse ox to measure o2 sats
PATIENT-CENTERED CARE
Nursing Care
Support and encourage parents in the
general care of their child, Promote
parent-infant bonding, Promote healthy
self-esteem throughout child's dev,
Post op- clean site w/ NS, diluted
peroxide, no pacifiers, CL place on
back, CP on abdomen for drainage
and change position freq, maintain IV
fluids
Therapeutic Procedures
CL- repair is typically done
between 2-3 months of age,
revisions are usually required
in severe defects
CP- repair is typically done
between 6-12 mo of age, most
require a 2nd surgery
ACTIVE LEARNING TEMPLATES
__________
Pathophysiology Related Health Promotion and
to Client Problem Disease Prevention
Cleft lip- from incomplete fusion of the oral Early intervention, elbow restraints to
cavity during intrauterine life prevent injury while healing, minimize
Cleft palate- from incomplete fusion of the risks of infections (hand hygiene), parent-
paltates during utero infant bonding
Can occur together, be unilateral or bilateral
SAFETY
CONSIDERATIONS
Expected Findings
Aspiration risk- feed
Cleft lip- visible separation from the upper lip infant in upright position
Infection- post-op and
towards those nose
Cleft palate- visible or palpable opening of the ear infections
monitor temp,
palate connecting the mouth and nasal cavity
Monitor weight, I+O
Monitor for hearing
complications and
feeding complications
Specialized bottles w/
Diagnostic Procedures one way valve and
special nipple for
Inspection and palpation after birth, feeding, burp infant often
can be diagnosed w/ ultrasound Observe for sx of airway
before birth obstruction, hemorrhage,
laryngeal spasm
Complications
Medications Client Education -Ear infections and
hearing loss r/t
Analgesics post-op Teach parents that elbow
restraints may be required until
altered structure and
Oxygen PRN
lip/palate heals, proper use of recurrent otitis
restraints, post-op diet and media,
feeding techniques, proper care of
-Speech/language
operative site, sx of infection impairment- (CP)
-Dental problems
Interprofessional Care
plastic surgeon, orthodontist,
speech-language pathologist,
pediatrician, nurse, audiologist,
social worker, psychologist