Page 965 - Saunders Comprehensive Review For NCLEX-RN

8. An interprofessional team approach, including
audiologists, orthodontists, plastic surgeons, and
occupational and speech therapists, is taken to
address the many needs of the child.
B. Assessment (Fig. 33-1)
1. Cleft lip can range from a slight notch to a complete
separation from the floor of the nose.
2. Cleft palate can include nasal distortion, midline or
bilateral cleft, and variable extension from the uvula
and soft and hard palate.
C. Interventions

1. Assess the ability to suck, swallow, handle

normal secretions, and breathe without distress.
2. Assess fluid and calorie intake daily.
3. Monitor daily weight.
4. Modify feeding techniques; plan to use specialized
feeding techniques, obturators, and special nipples
and feeders.

5. Hold the infant in an upright position and

direct the formula to the side and back of the mouth
to prevent aspiration.
6. Feed small amounts gradually and burp frequently.

7. Keep suction equipment and a bulb syringe at

the bedside.
8. Teach the parents special feeding or suctioning
techniques.
9. Teach the parents the ESSR method of feeding
—enlarge the nipple, stimulate the sucking reflex,
swallow, rest to allow the infant to finish swallowing
what has been placed in the mouth.
10. Encourage parents to express their feelings about the
disorder.
11. Encourage parental bonding with the infant, including
holding the infant and calling the infant by name.
D. Postoperative interventions
1. Cleft lip repair
a. Provide lip protection; a metal
appliance or adhesive strips may be
taped securely to the cheeks to prevent
trauma to the suture line.

b. Avoid positioning the infant on

the side of the repair or in the prone
position because these positions can

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