Chapter 36- Patients With Special Challenges

Question 1

Developmental disability

Answer 1

Refers to insufficient development of the brain, resulting in some level of dysfunction or impairment

Question 2

Autism spectrum disorder

Answer 2

A term used to describe a group of complex disorders of brain development that vary greatly in signs and symptoms.

Question 3

Autism spectrum disorder patients may have a problem doing what kind of tasks?

Answer 3

They have extreme difficulty doing tasks that require multiple steps, one step directions are preferred

Question 4

Down syndrome

Answer 4

Characterized by a genetic chromosomal defect resulting in mild to severe intellectual impairment.

Question 5

Physical abnormalities that are associated with Down syndrome:

Answer 5

A round head with a flat occiput
An enlarged, protruding tongue
Slanted, wide-set eyes
Folded skin on either side of the nose, covering the inner corners of the eye
Short, wide hands
A small face and features
Congenital heart defects
Thyroid problems 
Hearing and vision problems

Question 6

The atlantoaxial joint

Answer 6

Where the first two vertebrae meet

Unstable in approximately 15% of people with Down syndrome

Question 7

Sensorineural deafness

Answer 7

Nerve damage, as a result from a lesion or damage to the inner ear

Question 8

Conductive hearing loss

Answer 8

Caused by a faulty transmission of sound waves, which can occur when a person has an accumulation of wax inside the ear canal or a perforated eardrum

Question 9

Cerebral palsy

Answer 9

A term for a group of disorders characterized by poorly controlled body movement

Question 10

Why do we closely observe the airway status of a patient with cerebral palsy?

Answer 10

Because these patients may have increased secretion production and difficulty swallowing, requiring aggressive suctioning to clear the airway

Question 11

Spina bifida

Answer 11

A birth defect caused by the incomplete closure of the spinal column during embryonic or fetal development, resulting in an exposed portion of the spinal cord

Question 12

Hydrocephalus

Answer 12

A condition where there is too much CSF in the brain causing pressure

Requires the placement of a shunt to drain excessive amounts of cerebrospinal fluid from the brain.

Question 13

Obesity

Answer 13

A complex condition in which a person has an excessive amount of body fat.

Question 14

Tracheostomy

Answer 14

A surgical procedure that creates a stoma through a patient’s skin and into an organ or other structures

Question 15

Stoma

Answer 15

Opening

Question 16

Tracheostomy tube

Answer 16

Keeps open the stoma from a tracheostomy

Question 17

DOPE

Answer 17

D- displaced, dislodged, or damaged tube
O- obstructed tube (secretions, blood, mucus, vomitus)
P- pneumothorax
E- equipment failure

Question 18

Patients who are on a mechanical ventilator at home…

Answer 18

Cannot breathe without assistance

Question 19

Internal cardiac pacemaker

Answer 19

A device implanted under the patient’s skin to regulate the heart rate

Question 20

Left ventricular assist device (LVAD)

Answer 20

A special piece of medical equipment that takes over the function of one or both heart ventricles.

Question 21

Shunts

Answer 21

Tubes that drain excess CSF from the ventricles of the brain to keep pressure from building up in the brain.

Question 22

Vagus nerve stimulators

Answer 22

Stimulate the vagus nerve at predetermined intervals to prevent seizure activity

Question 23

Colostomy or ileus Tony

Answer 23

A surgical procedure that creates an opening from the small or large intestine to the surface of the body that allows for elimination of waste products.

Question 24

Urostomy

Answer 24

A surgical procedure which connects the urinary system to the surface of the skin, allowing urine to drain through a stoma in the abdominal wall instead of through the urethra