T2-GI Disorders: Cleft Lip/Palate

Question 1

Cleft lip with or without Cleft palate is more common in males or females?

Answer 1

Males

Question 2

Cleft palate alone is more common in males or females?

Answer 2

Females

Question 3

Is cleft lip/palate familial?

Answer 3

Yes

Question 4

Cleft lip/palate is familial, can occur with associated defects with other _____ abnormalities, or environmental _____

Answer 4

With other chromosomal abnormalities or environmental teratogens

Question 5

Cleft lip is a failure of the ____ & _____ processes to fuse

Answer 5

Maxillary and median nasal processes

Question 6

The merging of the upper lip at midline is complete by ____

Answer 6

7-8 weeks gestation

Question 7

When does cleft palate appear?

Answer 7

When there is failure of the palatal shelves to fuse

Question 8

When do the palatal shelves fuse?

Answer 8

7-12 weeks gestation; tongue has to get out of the way in order for palates to fuse

Question 9

Can you have cleft lip without cleft palate?

Answer 9

Yes

Question 10

Can you have cleft palate without cleft lip?

Answer 10

Yes

Question 11

Can you have both cleft palate and lip together?

Answer 11

Yes

Question 12

Which is this: Cleft palate or lip

Involves soft palate, hard, palate or both

Answer 12

Cleft palate

Question 13

Cleft lip is only unilateral. T/F?

Answer 13

FALSE; it can be unilateral or bilateral

Question 14

If unilateral, under a nostril may be a ___ in lip or go all the way up into the floor of the nose.

Answer 14

Notch

Question 15

What else is going on in the first trimester?

Answer 15

N/V, so some docs don’t give prenatal vitamins or pt. may not be getting full benefit of taking vitamins

Question 16

What can help prevent cleft?

Answer 16

Folic acid

Question 17

____ defects affected by folic acid

Answer 17

Midline

Question 18

What is the goal for cleft lip/palate?

Answer 18

• Closure of the clients
• Prevention of complications
• Facilitation of normal growth and development

Question 19

Is it better to breast or bottle feed a baby?

Answer 19

Breast; the breast will conform better to odd shape of the lips

Question 20

What is the surgical correction for cleft lip?

Answer 20

Z-plasty

Question 21

Z-plasty is for the correction of cleft lip. When is this procedure usually done?

Answer 21

6-12 weeks of age in healthy infant

Question 22

How is cleft palate surgically fixed?

Answer 22

Palatoplasty

Question 23

Palatoplasy is the procedure for the correction of cleft palate. When is this usually done?

Answer 23

12-18 months; repaired right before development of speech

Question 24

What is harder to repair: cleft lip or cleft palate?

Answer 24

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)

Question 25

What is the post-operative care for cleft lip goal?

Answer 25

Protection of surgical site

Question 26

What are the 5 ways to achieve the goal of "protection of surgical site" for a post-operative care for cleft lip?

Answer 26

1. Never position on stomach 2. Elbow restraints 3. Oral and wound care 4. Comfort measures/pain control 5. Logan's bar or steri strips

Question 27

Used to hold and protect suture line

Answer 27

Logan's bar or steri strips

Question 28

Cleft lip: Post op What are immediate nursing problems?

Answer 28

Bleeding Infant upset Nose breathers (so won't be able to breathe through nose--inflammation)

Question 29

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?

Answer 29

- Elbow restraints - Issues with AIRWAY - Sign of BLEEDING - Sucking pacifers or straws= NO - Avoid UTENSILS till healed

Question 30

Cleft palate post op: | Progress diet to?

Answer 30

Slenderized food with progression to soft diet

Question 31

Cleft palate: Post op? How do they drink?

Answer 31

Cup

Question 32

Cleft palate: Post op What are some complications?

Answer 32

- Middle ear infections - Nasopharyngeal infections - Sinus infections - Associated hearing loss - Speech delay

Question 33

What is the long term cleft palate/cleft lip goal?

Answer 33

Enhance or maintain a positive self-image

Question 34

Who else may be involved with cleft palate/cleft lip?

Answer 34

Speech therapy | Orthodontist

Question 35

What are some psychosocial issues for parents of cleft lip/cleft palate children?

Answer 35

- 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