Cognitive and Behavioral Disorders in Children Flashcards
(49 cards)
What is any type of intellectual disability defined as?
Cognitive impairment
What are cognitive impairments classified as?
mild, moderate, severe, or profound
What are the 3 components of determining a pediatric cognitive impairment?
IQ (70-75 or below), functional strengths and weaknesses, 18 years or less at time of diagnosis
What signifies a developmental delay?
A significant lag in a child’s physical, cognitive, behavioral, emotional, and/or social development in respect to developmental norms
If a child presents with irritability, no response to contact, decreased alertness to movement/voice, delayed/difficult speech, delayed gross motor skills, feeding problems, poor/abnormal eye contact during feeding, and dysmorphic features, what may this be a sign of?
cognitive impairment
What is the nurse’s responsibility when caring for a child with impaired cognitive function?
Educate child/family, early intervention program recommendations, teach child self-care skills, promote child’s optimal development, encourage play and exercise, provide means of communication
What are examples of means of communication?
receptive and expressive skills, verbal and nonverbal communication
What is the most common chromosomal abnormality of a generalized syndrome?
Trisomy 21 (Down Syndrome)
If a patient has a separated sagittal suture, oblique palpebral fissures, small nose with depressed nasal bridge, a high, arched, narrow palate and protruding tongue, excess skin in neck folds, one palmar crease, hypotonicity and hyperflexibility and wide spaces and planar creases between big and 2nd toe, what may this child be presenting with?
Down Syndrome
What kind of congenital heart malformations do most patients with Down Syndrome present with?
Septal defects (ASD/VSD)
What is the chief cause of death (combined with cardiac abnormalities) for a patient with Down Syndrome?
Respiratory tract infections
How would a caregiver manage a patient with Down Syndrome?
Regular vision and hearing screenings, regular thyroid function tests, and surgical correction of serious congenital anomalies
What is the prognosis for life expectancy of a pt with Down Syndrome?
> 80% survive to age 60 years and beyond
What is the nurses role in caring for a child with Down Syndrome?
Support family, Assist family in preventing physical problems (correct positioning and support, measures to reduce Respiratory tract infections, support feeding and nutrition)
How would a nurse help educate a family in regards to feeding and nutrition of a child with Down Syndrome?
Use long, straight-handled spoon to push the food toward the back and side of the mouth
Encourage fluids & high-fiber foods to prevent constipation
Nasal saline and suction prior to feedings
Why would a nurse have to educate a patient who is caring for a child with Down Syndrome that when holding the baby, they must give extra support to the head and neck?
Patients with Down Syndrome often present with muscle hypertonicity and this will give the babies less control of their neck muscles
What are important aspects to consider when educating a caregiver about hygiene for an infant with Down Syndrome?
Babies with Down Syndrome have very dry skin, so it is important to keep the skin moisturized and frequently apply lip balm to the baby as well as using minimal amounts of soap, so the baby’s skin will not dry out more
What is the most common inherited cause of cognitive impairment?
Fragile X syndrome
Which gender is more severely affected by Fragile X syndrome?
males
A patient is worried that because her brother has Down Syndrome, she may be a carrier of the gene and this gene may get passed along to her children. How would you educate this patient?
Down Syndrome cannot be inherited and it is just as likely to have a baby with Down Syndrome whether or not someone else in your family has Down Syndrome
A patient is discussing her pregnancy with you and begins talking about how she has been told that she is a carrier of Fragile X. She says that she is not worried that her baby will have this disorder, because this was just a chromosomal fluke that happened while she was in utero, and the baby would have just as likely a chance of getting Fragile X as a baby whose mom is not a carrier. How would you educate this patient?
Fragile X syndrome is a chromosomal abnormality that is inherited, so there is a good chance that her baby with either present with fragile X syndrome or will be a carrier of the gene, and this can be passed on to grandchildren as well
Which syndrome will have an abnormal gene on the lower end of the long arm of the X chromosome?
Fragile X syndrome
If a patient has 50-200 base-pair repeats of the gene mutation for fragile X, is this patient presenting with Fragile X syndrome?
No. This patient is a carrier of the Fragile X gene. If the patient had over 200 base-pair repeats, he/she would have Fragile X
What would common clinical manifestations of FXS be?
Long, narrow face with prominent jaw (prognathism)
Large, protruding ears
Large testes (macroorchidism) in postpubertal males
Strabismus
Mitral valve prolapse and/or aortic root dilation
Hypotonia/hyperflexibility
Mild to severe cognitive impairment
ADHD/ADD and/or Autistic-like behaviors
