Clef lip / Clef Palette

Incomplete fusion of Lip or Palate Occurs during First Trimester 1in 2000 Cause Unknown Increased incidence in families Can occur alone or together May be simple or bilateral with other deformities

Collaborative care

Nursing Plastic surgery Oral surgery Orthodontist Audiology Speech

Clef Lip/NAM

Naso alveolar Molding device

Naso alveolar Molding device

Clef lip repair / 2-3 Mos

Post Op care Position Child on side or back Maintain stabilizing Dressing Prevent Hand to Mouth movement Clear liquids -Half strength formula Use adaptive nipple or Brecht feeder Clean suture line with NS as ordered Give water after feeding

Clef palate Repair/ 9-18 Months

General Post op considerations (V/S LOC Pain ) Distraction Keep hard objects out of Mouth Take fluids with Cup Soft diet Follow each meal with water

Pyloric Stenosis

Manifestations of pyloric Stenosis (2-4 weeks after birth)

Projectile Vomiting Visible Peristaltic waves Olive size Mass in RUQ Irritable

Dehydration
Weight loss Small stools

Post Op care

VS weight Strict I and O Pain Management (Avoid pressure on incision) NPO Progressive diet when Awake Assess reaction to feeding Maintain Clean Abdominal dressing