Author Question: A newborn was admitted to the nursery with a complete bilateral cleft lip and palate. The physician ... (Read 15 times)

notis · **on:** Jun 28, 2018

A newborn was admitted to the nursery with a complete bilateral cleft lip and palate. The physician explained the plan of therapy and its expected good results.

However, the mother refuses to see or hold her baby. Initial therapeutic approach to the mother should be to:
a. Restate what the physician has told her about plastic surgery.
b. Encourage her to express her feelings.
c. Emphasize the normalcy of her baby and the baby's need for mothering.
d. Recognize that negative feelings toward the child continue throughout childhood.

Question 2

Caring for the newborn with a cleft lip and palate before surgical repair includes:

a. Gastrostomy feedings.
b. Keeping the infant in near-horizontal position during feedings.
c. Allowing little or no sucking.
d. Providing satisfaction of sucking needs.

Eunice618 · **Reply #1 on:** Jun 28, 2018

Answer to Question 1

ANS: B
For parents, cleft lip and cleft palate deformities are particularly disturbing. The nurse must place emphasis not only on the infant's physical needs but also on the parents' emotional needs. The mother needs to be able to express her feelings before the acceptance of her child can occur. Although discussing plastic surgery will be addressed, it is not part of the initial therapeutic approach. As the mother expresses her feelings, the nurse's actions should convey to the parents that the infant is a precious human being. The child's normalcy is emphasized, and the mother is assisted to recognize the child's uniqueness. A focus on abnormal maternal-infant attachment would be inappropriate at this time.

Answer to Question 2

ANS: D
Using special or modified nipples for feeding techniques helps to meet the infant's sucking needs. Gastrostomy feedings are usually not indicated. Feeding is best accomplished with the infant's head in an upright position. The child requires both nutritive and nonnutritive sucking.