Question

List 2 (two) specific nursing interventions for each of the following health issues commonly seen in Cerebral Palsy Clients

Health issue Nursing interventions/ care plan (minimum 2 each)

7.1) Aspiration/Recurrent chest infections

7.2) Oral/ Dental problems

7.3) Incontinence

7.4) Skin breakdown risk/ pressure injuries

Answer 1

1. Aspiration/Recurrent chest infections :

a) Keep suction machine available when feeding high-risk patients. If aspiration does occur, suction immediately.

b) Keep head of bed elevated when feeding and for at least a half hour afterward.

2. Oral/ Dental problems :

a)

3. Incontinence

a) to advise the elderly patients to reduce the intake of foods that cause bladder irritation, like caffeine, carbonated beverages, pepper and acid foods and drinks^. The bladder irritation these foods cause increases detrusor instability and enhances urge urinary incontinence.

b) Bladder training is appointed in the literature as the first treatment option for overactive bladder cases.

4. Skin breakdown risk/ pressure injuries

a) Skin Care

• Keep the skin clean and dry
• Investigate and manage incontinence (Consider alternatives if incontinence is excessive for age)
• Do not vigorously rub or massage the patients’ skin
• Use a pH appropriate skin cleanser and dry thoroughly to protect the skin from excess moisture
• Use water based skin emollients to maintain skin hydration where possible
• Apply barrier cream
  • RCH Nappy goo for prophylactic nappy care to healthy skin
  • Sudocream for healthy skin/nappy rash
  • Calmoseptine Ointment for broken down skin in nappy region
  • Orabase Protective Paste for broken down skin in nappy region
• Use chlorhexidine wipes daily ONLY around CVC sites and open wounds/open sternotomies

b) Redistributing pressure

Prevention strategies should involve the use of pressure relieving devices appropriately chosen for the patient, regular skin inspection and frequently redistributing the pressure by repositioning the patients frequently and safely.

• Employ appropriate manual handling techniques in line with Occupational Health and Safety guidelines when transferring and repositioning patients. Please adhere to Smart Move/Smart Lift guidelines.
• Provide transfer assistance devices. Example: Hoist to reduce friction and shear forces.
• Provide the right positioning aids and use of appropriate support surfaces to help reduce friction and shear.