Cognitive

Question 1

Clinical manifestations for Down syndrome

Answer 1

depressed nasal bridge
inner epicanthal folds
small nose
excess/loose skin on back of neck
high arched palate
large protruding tongue
wide space between big toe and 2nd toe
simian crease
decreased muscle tone

Question 2

down syndrome FOCAL HU

Answer 2

feeding difficulties
obesity
constipation, congenital heart defects
acute otitis media (inner ear infection)
leukemia
hypothyroidism
upper respiratory infections

Question 3

nursing care of down syndrome

Answer 3

family support
assist family in preventing physical problems
promote child’s development progress
assist with genetic counseling

Question 4

ASD (autism) social interaction deficits

Answer 4

abnormal eye contact often earliest sign
failure to smile
failure to orient to name
lack of imitation
lack of interactive play
lack of gesture use such as pointing and waving

Question 5

ASD behavioral impairments

Answer 5

rocking
flapping hands
head nodding
spinning
twirling
difficulty with change
self-injurious behaviors

Question 6

ASD communication deficits

Answer 6

absent to delayed speech

atypical language such as humming or grunting for extended periods, laughing inappropriately, or use of echolalia

Question 7

Nursing care management of ASD

Answer 7

therapy from multiple sources with the objective being positive reinforcement, increased social awareness, teach verbal communication skills, decrease unacceptable behavior
STRUCTURED routine is key!

Question 8

how to approach a child with ASD inpatient

Answer 8

meet them where they are

tell them what to do not what not to do

Question 9

diagnosis of ADHD

Answer 9

based on activity in at least 2 different settings and behavior present before age 7
boys > girls
give surveys to teachers and caregivers

Question 10

treatment of ADHD

Answer 10

behavior therapy and psychotherapy before meds this is the first line of treatment in children 4-5yo
pharm tx- methylphenidate (ritalin, concerta, methylin) and dextroamphetamine (dexedrine)
tricyclic antidepressants (imipramine)
clonidine

Question 11

ADHD med side effect management and nursing mgmt

Answer 11

stimulant side effects: wt loss, abdominal pain, decreased appetite, sleeplessness, high blood pressure and HR
meds are usually taken BID (breakfast and noon)
Drug holiday not recommended
give IR forms on empty stomach
need frequent evaluations for effectiveness