Hydrocephalus
What is Hydrocephalus?
Too much cerebrospinal fluid (CSF) within the ventricles of the brain which causes pressure changes in the brain and an increase in head size.
What is spina bifida?
Neural tube defect in which there is imperfect closure of the spinal vertebrae
After surgical repair of the cleft lip, what should the nurse do to prevent damage to the repaired lip?
Place elbow restraints on the infant.
What is hip dysplasia?
Head of the femur is partly or completely displaced as a result of a shallow hip socket
What causes trisomy 21?
True or False: Suspected hydrocephalus needs to be reported to the HCP promptly because delay in treatment can cause permanent brain damage.
True.
What prenatal supplement is recommended to prevent neural tube defects?
Folic acid supplementation during the early weeks of pregnancy. 400 mcg per day!
True or False: Infant cannot suck before or after surgery.
True. You wouldn’t want to apply tension to the sutures after surgery.
True or False: Treatment should be started as early as possible before ossification
True
How common is Down Syndrome?
1 in 700 live births
What is the classic sign of hydrocephalus?
An increase in head size (Bulging fontanelles)
*Nurses monitor for hydrocephalus by assessing fontanelles and head circumference.
Many infants with spina bifida develop a latex allergy. They should be taught to avoid foods associated with latex allergies. What are these foods? (3).
Bananas, avocados, kiwi
What do you use to feed an infant with cleft lip?
A syringe with rubber tip, a long nipple with a large hole attached to a squeeze bottle or a medicine dropper can be used to feed the infant.
What is one of the most reliable sign of hip dysplasia?
Limited abduction of the leg on the affected side
What type of defects are highly associated with down syndrome?
Congenital heart defects
How does a ventriculoperitoneal shunt (SHUNT) treat Hydrocephalus?
The shunt allows excess CSF to drain into the peritoneal cavity where it is absorbed.
How do you need to position an infant when they have been born with meningocele?
Place prone with a pad between the legs to maintain abduction.
Can place the infant on their side to allow a break from the prone position.
What would you do post-operatively when caring for an infant who received post-operative care? (3)
Prevent sucking/crying to prevent damage to sutures
Apply elbow restraints
Position infant
Name 2 different treatment methods hip dysplasia.
Which is first line of treatment?
Pavlik Harness- First line of treatment
Spica Cast- used if the condition is caught late or not resolving with the Pavlik harness
What puts infants at risk for having down syndrome?
Advanced maternal age (>35 years old)
Name 4/6 signs of increased cranial pressure (ICP) in infants.
High-pitched cry, unequal pupil sizes, bulging fontanelles, irritability or lethargy, poor feeding, abnormal vital signs (low HR).
What should the nurse do with the sac when a baby is born with a meningocele?
What is the patient with a cleft palate at risk for?
Increased risk of infections in the respiratory tract and middle ear.
*If not caught early, may cause deafness.
What type of assessments are important in those with spica casts?
Neurovascula
Name 3/5 manifestations of down syndrome.
vClose-set and upward-slanting eyes
Small head/round face
Flat nose and protruding tongue which affects sucking
Intellectual impairments
Congenital heart defects are HIGHLY ASSOCIATED WITH DS
How do you position the infant after feeding and why?
*Support the head!
They already can’t support their head because of its size, with hydrocephalus it is larger and even harder to control.
*After feeding, an infant should be kept in a side lying position because vomiting occurs easily (risk for aspiration).
Name 3 interventions when caring for an infant with spina bifida
Prevent infection of injury to the sac
Correct positioning for sac protection and to prevent contractures
Keeping the infant clean and dry
Educating and supporting the parents
Ensuring adequate nutrition
Cleft palate: What is done after feedings to prevent speech problems and issues with the child's teeth?
The mouth is rinsed with sterile water.
Name 3 nursing interventions for a child with hip dysplasia.
Nursery nurse or post-partum nurse observes the newborn closely to see if there are signs of hip dysplasia and reports them.
Teach parents about the Pavlik harness and how to care for their baby in the harness
Neurovascular assessments in those with spica casts
Keeping the cast clean and dry, assisting with feeding, position changes and eliminating waste
Never shove anything down into a cast to itch the skin, you risk injuring the skin and getting an infection.
Who is your favorite teacher?
Mrs. Lewellen!