1229 Exam 8: Mental Retardation

Question 1

What is mental retardation?

Answer 1

cognitive impairment, any type of mental difficulty or deficiency

Question 2

What are the signs and symptoms of mental retardation?

Answer 2

in infancy are sometimes not noticed at birth, they quit hitting higher developmental milestones, non responsive to contact, voice or movement, irritability, poor/slow feeding, poor eye contact during feeding, diminished spontaneous activity

Question 3

What is the diagnosis of mental retardation?

Answer 3

sub average intellectual function (IQ <75), onset before age 18, functional impairments (at least 2 of them):
communication, home living, community use, leisure, health and safety, self care skills, social skills, functional academics, work(very simple for MR patients), self direction

Question 4

What are the causes of mental retardation?

Answer 4

intrauterine infection and intoxication, trauma of prenatal, perinatal, postnatal, metabolic or endocrine disorders, inadequate nutrition, postnatal brain disease, chromosomal anomalies, prematurity, LBW, post maturity, environmental influences-fetal alcohol syndrome, born to drug addictive moms, unknown prenatal influences, psychiatric disorders with onset in childhood

Question 5

What are the classifications of mental retardation?

Answer 5

Educable/mild- IQ 50 to 75- go to school, might be able to pass subject area state test, different degrees of diplomas, can take GED, can still go to college with GED
Trainable/moderate-IQ 35 to 55- can do things but may not know why they are, can work with timber hills programs of slow paced assembly line work
Severe- IQ 20 to 40- homebound or can go to Timbers hill or similar place would just sit in day room all day
Profound- IQ < 20 to 25- total care, can not communicate emotions, very delayed, can not feed self, walk with constant supervision, might not know day from night

Question 6

What are the preventions of mental retardation?

Answer 6

Rubella immunization- OB will always pull titer
Genetic counseling-family hx of any genetic disorders
Use of folic acid supplements
educate about fetal alcohol syndrome
Educate about the lead exposure

Question 7

What are the nursing considerations of mental retardation?

Answer 7

older pt will stay with their pediatric dr, when parents get older their siblings will take them in, keep convo simple, what are there self help skills, like to color and write all day, will affect where IV is placed, want to mess up there life cycle as least as possible, children ingested some type of poison

Question 8

What is down syndrome?

Answer 8

born with extra chromosomes, increase w/ maternal age (35)-if older recommended amniocentesis, women are born w/ every egg they will ever have, the older a woman gets the older her eggs do also, men have fresh sperm so it is directly related to the mother’s eggs, even though lots of women in 20’s have DS babies

Question 9

Maternal Age in relation to down syndrome

Answer 9

Ages 20-24 - 1/1490
Age 35 - 1/400
Age 40 - 1/60
Age 49 - 1/11
Some studies show that paternal age over 42 can also increase risk of DS

Question 10

What are the clinical manifestations of down syndrome?

Answer 10

short, stocky stature
flat head with flat cranial features
short broad hands with a simian crease
Upward slanting eyes with prominent epicanthic folds (make them look Asian)
Large, protruding tongue
Low set ears
Short neck
Short nose with depressed nasal bridge
Extra wide spacing between first and second fingers and toes
Usually heavy bc of lack of exercise
Very loving sweet personalities, social butterfly, love when ppl clap for them
Very regimen oriented, shows they watch and food they eat
Do not drive
Speckled iris
Dental and visual abnormalities
Mental retardation
Protruding abdomen
Broad, stubby feet with a plantar crease between the 2nd and 3rd toes
Incurved little finger

Question 11

What are therapeutic management techniques of down syndrome?

Answer 11

Early intervention programs help with teaching language skill
Environmental enrichment stimulation programs- assist with learning self help skills
Treatment accompanying anomalies- asthma, heart problems, if they are obese then symptoms are worsened
Home care as needed- ususally just for initial teaching

Question 12

What is the prognosis of down syndrome?

Answer 12

significantly lower life expectancy than the normal person, increases after age 44

Question 13

What are the nursing considerations for down syndrome?

Answer 13

support the parents at the time of diagnosis (usually at birth)
Assist the family in preventing physical problems
more risk for cardiac manifestations