Nursing Care of Children with Physical or Developmental Challenges
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Questions and Answers

What is the primary characteristic of Pierre Robin Syndrome?

  • Tracheoesophageal atresia and fistula
  • Cleft palate and tracheoesophageal fistula
  • Glossoptosis and esophageal atresia
  • Micrognathia, cleft palate, and glossoptosis (correct)

    • What is the name of the apparatus used to shape the nostril in fetal surgery?

  • Esophageal stent
  • Tracheal dilator
  • Nasal mold apparatus (correct)
  • Cleft palate separator

    • What is the term for an abnormal or surgically made passage between a hollow or tubular organ and the body surface?

  • Atresia
  • Stenosis
  • Dysplasia
  • Fistula (correct)

    • What is the term for the obstruction of the esophagus?

    <p>Esophageal atresia</p> Signup and view all the answers

    What is the term for a small mandible?

    <p>Micrognathia</p> Signup and view all the answers

    What is the percentage of esophageal atresia cases associated with other mesoderm defects?

    <p>50%</p> Signup and view all the answers

    What is the primary difference between omphalocele and gastroschisis?

    <p>Presence of a covering membrane</p> Signup and view all the answers

    What is the name of the association between esophageal atresia and other mesoderm defects?

    <p>VACTERL association</p> Signup and view all the answers

    What is the typical location of the defect in gastroschisis?

    <p>Lateral to the umbilicus</p> Signup and view all the answers

    What is a common clinical feature of type B esophageal atresia?

    <p>Coughing spells</p> Signup and view all the answers

    What is the percentage of type D esophageal atresia cases?

    <p>1%</p> Signup and view all the answers

    What is the primary management approach for ankyloglossia?

    <p>Surgery</p> Signup and view all the answers

    When does the palate process typically close during fetal development?

    <p>9th-12th week</p> Signup and view all the answers

    What is the common incidence pattern of neurodevelopmental disorders in different populations?

    <p>Higher incidence in Asian population, lower in African-American population</p> Signup and view all the answers

    What is the potential cause of cleft lip and palate?

    <p>Hereditary and environmental factors, including viral infections and folic acid deficiency</p> Signup and view all the answers

    What should be assessed in children with cleft palate?

    <p>Other congenital anomalies</p> Signup and view all the answers

    What is the characteristic of cleft lip?

    <p>A failure of the maxillary and median nasal processes to fuse</p> Signup and view all the answers

    Study Notes

    Fetal Surgery and Pierre Robin Syndrome

    • Fetal surgery can be performed in utero between 2-10 weeks to repair nasal mold apparatus to shape better nostrils.
    • Pierre Robin syndrome is a triad of micrognathia (small mandible), cleft palate, and glossoptosis (tongue malpositioned downward).

    Tracheoesophageal Atresia and Fistula

    • Tracheoesophageal atresia is an orifice or passage in the body that is closed or absent.
    • Fistula is an abnormal or surgically made passage between a hollow or tubular organ and the body surface, or between two hollow or tubular organs.
    • Esophageal atresia is an obstruction of the esophagus.

    Esophageal Atresia Classification

    • Type D: 1% Proximal and distal fistulas (“Double Fistula”)
    • Type E: 4% No atresia of the esophagus

    VACTERL Association

    • Vertebral anomaly
    • Anal atresia
    • Cardiac anomaly
    • Tracheoesophageal fistula
    • Esophageal atresia
    • Renal anomaly
    • Limb malformation
    • About 50% of cases are associated with other mesoderm defects.

    Clinical Features

    • Coughing spells (saliva overflows from the esophagus into the trachea)
    • Rales
    • Cyanotic attacks

    Omphalocele and Gastroschisis

    • Omphalocele: a central defect through the umbilical ring, covered by a thin membrane (can be ruptured), with intestines, liver, and other organs outside the abdomen in a sac.
    • Gastroschisis: a lateral defect to the right of the umbilicus, no covering membrane (can have fibrous matter), with intestines outside the abdomen through a hole.

    Commonly Affected Systems

    • Skeletal system
    • Gastrointestinal system
    • Nervous system
    • Physical and developmental challenges

    Ankyloglossia (Tongue Tied)

    • Abnormal restriction of tongue by an abnormally tight frenulum
    • The only management is surgery.

    Cleft Palate and Lip

    • Failure of the maxillary and median nasal processes to fuse
    • Can range from a small notch in the upper lip to total separation of lip and facial structure
    • Can be unilateral or bilateral
    • More common in boys
    • The palate process closes at 9th-12th week of intrauterine life
    • Usually occurs in conjunction with cleft lip.

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    Description

    This quiz covers the nursing care of children born with physical or developmental challenges, including commonly affected systems such as skeletal, gastrointestinal, and nervous systems. It also touches on the causes and incidence of these challenges.

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