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Peds 3

Physical Development Disorders

Fusion of maxilla and nasal processes occurs in utero when? 5-8 weeks
Defined as an opening in the palate Cleft Palate
Closure of palate usually occurs in utero when? 9-12 weeks
Frequent otitis media due to improper function of eustacian tubes occurs with this Cleft Palate
Surgical repair of ______ should be done ASAP. Revision may be needed at what age? cleft lip; 4-6 yo
Can be detected and repaired in utero by sonogram cleft lip
Sx repair postponed until 6-18 mo to allow anatomical changes to occur cleft palate
Position for feeding with cleft palate? Upright and burp frequently
Breastfeeding may resume at what time after sx repair of cleft palate? 7-10 days
Post-op cleft lip and palate: Position On side. Later placed in infant chair
TEA needs to be R/O in any baby born to a woman with what? polyhydramnios
Cardiac, Renal, CNS, and GI anomalies are often comorbidities occuring with what? TEA
The 3 Cs are watched for in infants with what? TEA
What are the 3 Cs? Coughing, Choking, Cyanosis
What do you do if 3 Cs present? make NPO and call doc
Sx repair and preventing aspiration PN and e-lyte imbalance is the goal for management of what? TEA
What position do we put baby with TEA in? Prevent aspiration. HOB 30, Car or infant seat
Why are ATB used with TEA? Probably already aspirated
How to run feeding r/t TEA By gravity NEVER pressure
What are some sign of TEA anastamosis leak? When would we see this? prurulent drainage, Increased WBC, temp instability....7-10 days post-op when sutures dissolve
What two things are included in teaching after herniorphy? Sponge baths, turn diaper down
What is the greatest concern with umbilical hernia? Strangulation of bowel
What are hallmark signs of ICP? Bulging fontanelles, sunset eyes
What are the early signs of ICP in infants? Late? Early= Bulging fontanelle, increased head circ Late=High pitch cry
What are sign of ICP in children? Why the difference? V, HA, Seizures. Closed cranial sutures
Acetamazolamide (Diamox) is used to treat ICP, because it does what? Promotes secretion of fluid
Post-op position for shunt Supine, NOT on operative side.
IV corticosteroids and anticonvulsants (Tegretol, Dilatin, Valium, and Phenobarb) are given what? Recover from ICP
How much folic acid to prevent neural tube defects? 0.4 mg/day prior to preg, then 4 mg/day
When is AFP assessed? What does increase indicate? 15 weeks preg; increase indicates open spinal lesion
What is done for definitive Dx open spinal lesion? Amniocentesis
Intrauterine infection, malnutrition, and anoxia can contribute to what? Microcephaly
Meninocele has/does not have neuro deficits Does not
Myelomeningocele has/does not have neuro deficits Has
No motor or sensory function below level of problem. Lack bowel/bladder control. Frequently have talipes, hip dysplasia, hydrocephalus Myelomeningocele
Pre-op care for mening. issues includes sterile what? What position? gloves and linens, prone with towel under abd or on side with folded diaper between legs
Cast for talipes may need changes how often d/t rapid growth 1-2 weeks
Cast for talipes removed at ____ wks, then may need Denis-Brown splint or _______ shoes 6, high top
Splint for talipes may be worn how long? Up to one year
Created by: mreedy