Peds Test 3
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A congenital defect of the lip that varies from simple notching of vermillion border on one side to bilateral fissure or opening is:
Problems that are associated with cleft lip are:
Surgical repair of a cleft lip is __________.
- IV fluids
- avoid sucking for 1-2 weeks
- feed with rubber tipped syringe
- Breck feeder (bulb tipped syringe)
- H2O first, then formula
- upright for feeding, burp every 1/2 oz
- no suctioning or tongue depressors
- position inclined on back/upright in infant seat or on right side NEVER on abdomen
Suture line care after a cheiloplasty:
- do not allow to crust (scarring)
- use saline/sterile water
- antibiotic ointment
- Logan Bar- prevents strain/stress
- sutures usually removed 7-10 days
- cuddle (crying puts strain on suture line)
__________ is a congenital defect resulting in failure of the hard palate to fuse, leaving passageway between nasopharynx and nose.
Problems associated with cleft palate:
- increased resp/middle ear infections
- can interfere with bonding
- speech problems
- dental problems
Surgical repair of a cleft palate should be performed around __ to __ months of age and is called a __________.
__________ is the abnormal narrowing of the pyloric sphincter caused by overgrowth of muscle at the pylorus. Hypertrophy causes the stomach to become __________.
- pyloric stenosis
S/s of pyloric stenosis appear when the infant is about __ to __ weeks old; includes occasional vomiting that becomes __________ with a very sour smell. Other s/s:
- 2-3 weeks old
- sunken fontanels
- dry and mucous membranes
- no tears w/crying
- inelastic skin turgor (tenting)
- pallor, gray skin with dark circles
- weight decrease
- decreased UOP
- urine specific gravity >1.030
- VS changes (weak pulse)
Pyloric stenosis is usually dx by __________.
__________ is performed by splitting the hypertrophied pyloric muscle down to the submucosa.
While awaiting surgery for pyloric stenosis, they might recommend a small amt of __________ to be added to the formula to thicken it and give extra nutrients.
__________ is commonly given to infants with pyloric stenosis.
How should you feed an infant after a pyloromyotomy?
feed slowly and upright, burp frequ, position on right side after feedings
Who gives the feeding schedule for an infant who had a pyloromyotomy?
After a pyloromyotomy, the infant may vomit within the 1st 24 hrs and have a brief dumping syndrome; this is __________.
__________ is a medical emergency and is described as the telescoping of the bowel into itself usually at the __________ valve.
- ileocecal valve
Intussusception usually affects males under __ years of age.
Intussesception may correct itself, and the prognosis is good if it is treated in the first __ hrs.
Fetal shunt: from the umbilical vein to inferior vena cava
Fetal shunt: from the right atrium to the left atrium
Fetal shunt: from the pulmonary artery to the aorta
CHF tx goals:
- improve cardiac function: Digoxin, ACE inhibitors
- remove accumulated fluid: diuretics, monitor K level (low K can lead to dig toxicity), fluid and Na restrictions, monitor I&O, daily wts
- decrease cardiac demands: bed rest, small freq feedings; soft nipple with enlarged hole; semi-fowler's
- increase tissue oxygenation: supplemental O2, inrease iron foods; supplements as needed
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