- Vital signs
- Respiratory status
- Feed slowly
- Lie down to left or right side
- Use suitable equipments
- Burp frequently (after every 15-30 ml of fluid)
NURSING CARE SYSTEM FOR PATIENTS WITH CLEFT LIP AND PALATE AT ERCIYES UNIVERSITY FACULTY OF DENTISTRY
Breathing
- Assess respiratory status
- Keep suction equipment and bulb syringe at bedside
- Provide cool mist
- Reposition every 2 hours
Handan Varol, Nükhet Kütük
Erciyes University Faculty of Dentistry Department of
Oral and Maxillofacial Surgery
Last Preoperative Time
- Assess oral cavity every 2 hours
- Cleanse suture line - saline or sterile water
- 4 times/day
- After feeding
- Clear nutrients 2-3 hours before the surgery
- Oral intake stopped
Bottle Feeding
Feeding splint - 1 to 3 days after the birth
Hygene procedures
After Birth
- Help parents to hold the infant
- Surgical procedures and outcomes
- Show pictures of repaired CLP’s
- Encourage family
- Interact other family members
- Keep in touch with friends
- Participate in caretaking
Treatment Plan
- 1-3 day……..…...… Orthodontic feed splint
- 1 week……………………………………..Diagnose
- 3-4 month………………………………Lip surgery
- 9-18 month……………………….Palate surgery
- 2 years……………………Logopaedic exercises
- 7-9 years…………….Alveolar reconstruction
PRENATAL
- Prenatal counselling
- Basic information about the malformation
- Support and encourage
PURPOSE
- Promote continuity and quality of care for CLP patients
- Present our nursing care system
- Present educational materials
Solid Foods
Nutrition
Brest Feeding (only cleft lip)
- Encourage brest feeding
- Remind for upright position
- Express other methods
- 4-6 months
- Use spoon
- Upright position
- Intravenous fluids(1/3 poliflex ,total volüme 1000ml/day)
- Begin clear liquids
- Fully awake patient
- Use syringe, dropper or spoon
- Do not allow pacifiers
- Explain care and treatment
- Parents are involved in wound care
- Demonstrate feeding techniques
- Provide written instructions for follow-up care (e.g. brochures)
Cleanse the cleft areas – 5 to 15 ml of water
Cotton swab - crusts and ointment application
- Temperature, pulse and respiration (TPR)
- Oxygen saturations
- Hourly TPRs (for 4 hours)
- 4th hourly TPRs
Pain relief half an hour before feeding
- Assess bleeding -Excessive swallowing!
- Contact surgery team
Conclusion
- Providing comprehensive information to the parents is important
- Close relationship and written instructions enhances the results of the treatment
Wound care
Postoperative recommendations for home care
- Use soft elbow restraints
- Scar prevention (Steri-Strips)
- Nasal splints
- Pain control
- Lip dressing, 3-5 days postop.
- Daily wound care, 1 week
- Massage+silicone gel sheet, two finger technique - 4 months