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Nursing care of children with cleft lip and palate
PRÁŠKOVÁ, Kateřina
This bachelor thesis deals with the nursing care of children witch cleft lip defects and palate. The prevalence of cleft defects has decreased thanks to modern prenatal diagnosis, but cleft palate and cleft lip are still at the top of the ranking among the most common congenital developmental defects. The thesis is divided into two parts, a theoretical part and an empirical part. The theoretical part describes the anatomy and physiology of the oronasal region, prenatal care, classification of cleft lip and palate, history of treatment and current surgical treatment, nursing process and multidisciplinary care. In this bachelor thesis three objectives were set. The first objective was to determine the nutritional nursing care of children with cleft lip and palate defects. The second objective was to determine the nursing care after surgery for a child with cleft lip and palate defect. The third and final objective was to determine parental awareness of cleft lip and palate defect in their children. The research investigation of the bachelor thesis was conducted through qualitative research in the form of a case study. The case study includes a description of the situation, a description of the factors that caused the situation, a description of the procedures used and their impact on the resolution of the situation, and in particular an evaluation of the resolution of the situation and, where appropriate, suggestions for further action. The content structure became case studies: the characteristics of the client and his/her initial situation. To obtain this information, an analysis of medical records, nursing documentation, child observation and the nursing process was carried out to create a detailed nursing case history of children with the problem using the Nanda Taxonomy II. Based on the information obtained, we developer a nursing plan for two children with surgical correction of this defect. Categorization of the case study was done. According to the detailed analysis of the nursing case studies, we have created categories and subcategories, which are discussed and described in detail under each scheme. The research investigation was conducted in a specialized unit dedicated to the treatment of developmental defects of the lip and palate in pediatric patients. The research was conducted from February to mid-April 2023. Parents of children with cleft defects were interviewed to supplement the information. All of this information that was found is completely anonymous. The interview included a total of 23 pre-designed questions. Individual interviews were recorded on a mobile phone and then transcribed verbatim into Microsoft Word. Then, the parents´ interviews were analyzed and categorized using the pencil-paper method. Based on the research investigation, it was found that care is provided individually, according to the congenital defect in the lip and palate and the extent of its damage. This determines the timeliness of surgical treatment and associated nutrition. A detailed analysis of the nursing process and the creation of nursing diagnoses related to the specific patient with a congenital defect in the lip and palate region was performed. The research revealed that careful professional awareness of the parents was taken care of. Despite the fact that mothers reported sufficient awareness, some sought further information on the internet and/or in leaflets from the doctor. In terms of nursing care for children after surgery, these children are hospitalized as soon as possible after birth. These early surgeries are done for faster healing and from a psychological point of view. This bachelor thesis can be used in theoretical teaching in nursing process focused on surgical issues. In my opinion, this thesis could also be used to expand the awareness of cleft defects among health care professionals in practice.

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