Cognitive/NeuroMusc Flashcards
what IQ level is considered a cognitive impairment
Less than 70 to 75
what is another name for down syndrome?
Trisomy 21
What occurs with down syndrome?
Third copy of 21st chromosome
what is a risk factor of down syndrome?
Older, maternal age
s/sx down syndrome
Lower inner epicanthal folds
Depressed nasal bridge
Small nose
High arched palate
Protruding tongue
Simian crease
Wide gate
Floppy
what are the two main associated illnesses with down syndrome?
CHD
Leukemia
autism spectrum disorder sx
abnormal eye Contact
failure to smile at two months
Lack of imitation
No joint attentiveness
Communication issues with autism
Delayed speech
Expressive aphasia
Humming, grunting
echolalia
Behavioral issues with autism
repetitive fixations
Rocking back-and-forth
Flapping hands
Spin, twirl
Self injury
what are good ways to manage autistic patients
Simple, nonverbal, communication
Dim lights
Limit people in the room
Ask parent best way to talk
Communication boards
Limit waiting time
should you tell an autistic patient what to do or what not to do?
What to do
T/F, you should use figures of speech when talking to autistic patients
False
ADHD
inattentiveness
Impulsiveness
Hyperactivity
when is ADHD usually diagnosed
Around second grade
Boys more likely
What are the associated problems with ADHD?
depression, anxiety
School, academic problems
Conduct disorders, defiant
treatment for ADHD
Behavioral psychotherapy
Psychostimulants
nursing Care related to drug therapy for ADHD
Give AT breakfast and noon time
Give on empty stomach
No drug holidays
Distraction free periods
Set timers for tasks
Fidget toys
Cerebral palsy
Permanent non-progressive disorder of the brain affecting activity limits
how to diagnose cerebral palsy
Thorough exam evaluating milestones
Most diagnosed as failure to meet milestones
Persistent, primitive reflexes
sx cerebral palsy
floppy/limp body structure
Uses one side of body only
Feeding difficulty, drooling
Persistent tongue reflex
Ataxia
writhing movements
when does hypotonic cerebral palsy occur in children?
At birth
when does hypertonic cerebral palsy occur in children?
Greater than one year old
What is the most common type of cerebral palsy?
spastic
Scissoring, toe walking
what are common associated problems with cerebral palsy?
Bowel and bladder incontinence
Contractions
Feeding difficulty – G-tube
treatment for cerebral palsy
PT, OT, speech therapy
Botox
Assistive devices
Meds - symptomatic
muscular dystrophy
Inherited chronic muscle weakness
Duchenne
T/F only females are affected
False, females are the carriers, but males are affected
early onset of symptoms for muscular dystrophy
Regress in milestones
Difficulty running, climbing stairs
what is Gowers sign?
The child is unable to stand up from sitting down without having to utilize ankles, knees and torso
Pseudo hypertrophy
fat infiltration
at what age do muscular dystrophy patients lose the ability to ambulate
10 to 12 years old
at what age do muscular dystrophy patient start to fully deteriorate
Around 27 years old
complications of muscular dystrophy
Contractures
Atrophy
Obesity
Cardiac symptoms
How to treat muscular dystrophy
maintain function in unaffected muscles
Cardiac – digoxin, diuretics
Respiratory – mechanical vent
Range of motion exercises
CT GaINAc transferase
Glutamine and creatine
spina bifida
Malformation of spine in which vertebrae fails to close
Failure of neural plate to develop
What is a common cause of spina bifida?
Low folic acid levels, vitamin B 12
at what point of gestation does spina bifida normally occur in
Fourth week of gestation
Occulta, spina bifida
No visible defects
Only vertebrae affected
spina bifida cystica
External sac protrusion, visible
Meningocele
encased spinal fluid and meninges
No neurodeficits
Myelomeningocele
meninges, spinal fluid and nerves, trapped in external sac
sx with Myelo meningocele
hydrocephalus – big head full of fluid, not able to drain
Bowel and bladder incontinence
Sunset eyes
Poor muscle tone
what is a priority, nursing intervention with hydrocephalus?
Measure head circumference regularly
Preop for spina bifida
Sterile, nonadhesive dressing
Place on belly prone
Avoid rectal temp
NPO
Catheter placement
Postop spina bifida care
vital signs, weight, I/O
Keep prone
Clean intermittent cath
Bowel training
enema, fiber, laxatives
Head circumference, and fontanelle measurements
What type of environment should be maintained for these young spina bifida patients?
Latex free
