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NURS 332 > Chapter 18: Cognitive & Sensory Impairment > Flashcards

Chapter 18: Cognitive & Sensory Impairment Flashcards

1
Q

What is a cognitive impairment?

A

any type of mental difficulty or deficiency

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2
Q

What is the outdated name for intellectual disability? What are the 3 components of intellectual disability?

A
  • intellectual disability FKA mental retardation
  • 3 components:
    1. intellectual function = IQ < 70 - 75
    2. functional strengths and weaknesses
    3. age younger than 18 at time of diagnosis
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3
Q

What is a developmental disability? What are the 3 components?

A
  • developmental disability: any delay or lag in a child meeting their milestones
  • 3 components:
    1. physical
    2. cognitive
    3. social
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4
Q

What are some examples of early behavioral signs of cognitive impairment?

A
  • no response to eye contact, voice, or movement
  • irritability
  • poor or slow feeding
  • poor eye contact during feeding
  • diminished spontaneous activity

– these are not diagnositc – these just help prompt us to take a closer look

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5
Q

What are some primary prevention strategies for cognitive impairment?

4 strategies

A
  1. support for preterm and high-risk infants
  2. rubella immunization
  3. genetic counseling
  4. maternal counseling
    * folic acid supplements
    * fetal alcohol syndrome
    * lead exposure
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6
Q

What is Down syndrome? What causes Down syndrome? What are some characteristic physical features of Down syndrome?

6 characteristics

A
  • AKA trisomy 21 – extra chromosome 21
  • etiology is unknown but linked with increased incidents with advanced maternal age
  • characteristics:
    1. upward, slanted eyes
    2. large forehead
    3. flat nasal bridge
    4. protruding tongue
    5. hypotonia – not very strong muscles
    6. mottled skin
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7
Q

What are some congential anomalies that result from Down syndrome?

6 anomalies

A
  1. heart defects – usually septal defects
  2. renal disorders
  3. Hirschsprung disease
  4. tracheoesophageal fistula
  5. altered immune function
  6. skeletal defects – atlantoaxial instability
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8
Q

What is fragile X syndrome? How is it passed down? What are some classic physical characteristics of fragile X syndrome?

13 characteristics

A
  • fragile X: genetic disorder that results in a lack of production of the FMRP protein, which is needed for brain development
  • X-linked dominant genetic inheritance – more common in males than females
  • characteristics:
    1. large head circumference
    2. long face
    3. prognathism – protrusion of mandible
    4. large ears
    5. long palpebral fissures
    6. strabismus – crossed eyes
    7. mitral valve prolapse
    8. hypotonia
    9. macroorchidism – increase of testicular volume by at least 2x for age
    10. high, arched palate
    11. hyperextensible finger joints
    12. palmar crease
    13. flat feet
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9
Q

What are some behavioral features of fragile X syndrome?

6 features

A
  1. mild to severe cognitive impairment
  2. delayed speech and language
  3. hyperactivity
  4. hypersensitivity
  5. autistic-like behaviors
  6. intolerance to a change in routine
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10
Q

How is fragile X syndrome therapeutically managed?

3 management

A
  1. administration of serotonin agents to help with behavior control
  2. administration of stimulants for hyperactivity (similar to those given for ADHD)
  3. administration of protein replacements or gene therapy
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11
Q

What is the difference between slight and profound hearing loss?

A
  • slight to moderately severe hearing loss: residual hearing is enough to process linguistic information through use of hearing aid
  • severe to profound hearing loss: processing of linguistic information is impossible with or without a hearing aid
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12
Q

What are some causes of hearing impairment?

7 causes

A
  1. anatomic malformation
  2. low birth weight
  3. ototoxic drugs
  4. chronic ear infections
  5. perinatal asphyxia
  6. perinatal infections
  7. cerebral palsy
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13
Q

Distinguish between conductive, sensorineural, and mixed conductive-sensorineural hearing loss? How they treated?

A
  • conductive: sound cannot pass through the outer and middle ear
    – hearing aids help amplify noise
  • sensorineural: inner ear damage that results in nerve deafness
    – cochlear implants
  • mixed conductive-sensorineural: damage to both inner and outer/middle ear
    – this may be caused by recurrent otitis media with complications
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14
Q

What are some manifestations of hearing impairment in infancy?

4 manifestations

A
  1. lack of startle reflex
  2. absence of babbling by age 7 months
  3. general indifference to sound
  4. lack of response to the spoken word
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15
Q

What is the main concern with profound hearing impairment?

A

speech development

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16
Q

How can hearing impairment be prevented?

3 preventions

A
  1. treatment and management of recurrent otitis media
  2. prenatal preventive measures
  3. avoid exposure to noise pollution
17
Q

What is considered a visual impairment?

A

visual loss that cannot be corrected with regular prescription lenses

18
Q

Distinguish between partially sighted and legal blindness?

A
  • partially sighted: acuity of 20/70 to 20/200
  • legal blindness: acuity of 20/200 or less
19
Q

What are some causes of visual impairments?

4 causes

A
  1. perinatal or postnatal infections – gonorrhea, chlamydia infection, rubella, syphilis, toxoplasmosis
  2. retinopathy of prematurity
  3. perinatal or postnatal trauma
  4. unknown causes
20
Q

Why do we have to be cautious with medications when treating conjunctivitis in children?

A
  • steroid eye drops may make eye infections worse and cause visual acuity problems
  • systemic steroids cause immunosuppression which can cause acuity problems
21
Q

How is visual acuity assessed in infancy and childhood?

A
  • infancy:
    1. check responses to visual stimuli
    2. parental observations and concerns
    3. expect binocularity after age 4 months
  • childhood:
    1. visual acuity testing – Snellen charts (maybe not be letters depending on age; could be shapes, colors, pictures, etc.)
22
Q

What are some preventions of visual impairment for children?

4 preventions

A
  1. prenatal care
  2. prevention of prematurity
  3. rubella immunizations
  4. safety counseling to prevent eye injuries
23
Q

What is a retinoblastoma?

A

a congenital malignant tumor, arising from the retina

24
Q

How is retinoblastoma diagnosed?

5 diagnostic indicators

A
  1. leucokoria – whitish “glow” in the pupil – most common sign
  2. strabismus – second most common sign
  3. red and painful eye
  4. glaucoma
  5. blindness – late sign
25
Q

How are retinoblastomas treated?

A
  • early-stage, unilateral tumor:
    – irradiation
    – cryotherapy
    – attempt to preserve useful vision in affected eye
  • bilateral tumor:
    – attempted to preserve useful vision in the least affected eye
  • advanced tumor:
    – enucleation – removal of the eye from the orbit
    – chemotherapy
26
Q

What are autism spectrum disorders (ASDs)?

A
  • complex neurodevelopmental disorders of brain function
  • a wide range from mild to severe (high to low functioning)
  • autistic disorder and Asperger syndrome are used almost interchangably
27
Q

What are some theories regarding the causes of ASD?

A
  • hereditary
  • medical problems
  • immune factors may increase incidence
  • environmental factors may increase incidence
  • high risk of recurrence in families
  • higher incidence in males vs. females
  • no supportive evidence links ASD to MMR vaccine or vaccines with thimerosal
28
Q

What are the 4 diagnostic criteria for ASD?

A
  1. impairment in social interaction
  2. impairment in communication
  3. restrictive, repetitive, and stereotyped patterns of behavior, interests, and activities
  4. delays or abnormal functioning with onset before 3 years old
29
Q

What are some ways to therapeutically manage ASD?

7 management

A
  • no treatment – management therapies used instead
    1. minimize input to prevent overstimulation
    2. have familiar faces in the room
    3. keep to a routine to minimize anxiety
    4. behavior therapy
    5. speech therapy
    6. family counseling – alleviate parents’ feelings of guilt and shame
    7. encourage home care for children

NURS 332 (13 decks)

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