f. Nursing interventions.
(1)
Monitor respiratory status.
(b) Perform pulmonary physiotherapy.
(c)
Suction as necessary.
(2)
Administer antibiotics and parenteral fluids as ordered.
(3)
Accurate I&O.
(4)
Observe for signs of complications (that is, pneumothorax).
(5)
Maintain gastrostomy tube feedings.
(6) Give the baby a pacifier to satisfy his sucking needs but only when he
can safely handle secretions.
(7)
Offer the parents support and guidance and encourage bonding.
(8) Positioning before and after surgery varies with the doctor's philosophy
and the child's anatomy.
(a) Supine with his head low to facilitate drainage.
(b) Head elevated to prevent aspiration.
11-7.
DOWN'S SYNDROME
a. Down's syndrome is referred to as a chromosomal abnormality involving an
extra chromosome (number 21). It is characterized by a typical physical appearance
and mental retardation. The extra chromosome is known as trisomy 21, an aberration
in which chromosome 21 has three copies instead of the normal two because of faulty
meiosis of the ovum or the sperm. It may be inherited or not inherited. Overall, it
occurs in 1 per 650 live births. The incidence increases with maternal age, especially
after age 35. Women over 35 years old account for bearing 50 percent of all children
with Down's syndrome. Paternal age doesn't seem to play a significant part. This
suggests that sometimes the chromosome abnormality responsible for Down's
syndrome results from deterioration of the oocyte because of age alone or because of
the accumulated effects of environmental factors.
b. Signs and symptoms. See figure 11-4 for a typical Down's syndrome child.
(1)
Mental retardation is obvious as infants grow older.
MD0922
11-11
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