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Maternal Child Nursing (Exam 1) > Exam 1 (Cognitive Impairment of the Child) > Flashcards

Exam 1 (Cognitive Impairment of the Child) Flashcards

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1
Q

Are are the 3 components of Cognitive Impairment (Mental Retardation)?

A
  1. low intellectual functioning (IQ score, must be less than 70-75)
  2. functional strengths and weaknesses (at least two or more adaptive skill areas. Self-help skills. 10 different domains. Called functional domains.
  3. age less than 18 at diagnosis
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2
Q

What is the Diagnostic and Statistical Manual of Mental Disorders (DMS) used for?

A

Standard test to diagnosis physiological illnesses

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3
Q

What is the difference between developmental delay and cognitive impairment?

A

Developmental delay: with therapy, may get better

Cognitive impairment: permanent

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4
Q

What are some causes of Cognitive impairment?

A

May be familial, social, environmental or organic
Maternal problems can cause issues for baby.
If grows up without stimulation, a healthy baby will develop cognitive impairment.

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5
Q

What is the most common CI?

A

Down Syndrome

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6
Q

What are some events that may lead to CI?

A
  • Infection and intoxication
  • Trauma
  • Brain disease
  • Chromosome disorders
  • Environmental
  • Gestational
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7
Q

What are the classifications of CI?

A

Mild
Moderate
Severe
Profound

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8
Q

What is mild CI?

A

IQ (50-75) [Most common]
Characteristics: able to walk, talk, a little slow, mental age of 8-12 year old.
Educable: Learn to 3 to 6 grade level in math and reading.

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9
Q

What is moderate CI?

A

IQ (35-49)
Characteristics: delayed speech and motor, mental age 3-7. May be able to feed themselves.
Trainable: Can do factory work. Simple tasks

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10
Q

What is severe CI?

A

(20-35)
Characteristics: Little or no communication. Mental of a toddler. Constint supervision. May or may not be able to feed themselves.

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11
Q

What is profound CI?

A

IQ below 20

Characteristics: 24/7 care. Cognitive level of an infant.

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12
Q

What are some early red flags to CI?

A 
Dysmorphic features
Abnormal eye contact
Gross motor delay
Language delays
Feeding difficulties
Behavioral Changes
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13
Q

What is most crucial for nursing to assume when caring for a CI patient?

A

Always assume competency!

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14
Q

A nurse should always..

A

Promote child’s optimum development

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15
Q

Does a CI child need discipline?

A

CI children need to know about limits. Assume they can learn.

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16
Q

A nurse must teach sexuality to CI patients according to

A

according to developmental level. What is ok and what isn’t

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17
Q

Is play and exercise important for CI patients?

A

Very! Might have to adapt, but extremely important.

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18
Q

How can a nurse promote independents through self help skills?

A

Let the child dress themselves

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19
Q

What can decrease anxiety of a CI patient in a hospital setting?

A

All the patents to be involved. Helps decrease anxiety.

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20
Q

What are some preventions of Cognitive impairments.

A

Genetic screening, prenatal care, substance abuse.

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21
Q

What is down syndrome

A

An extra chromosome.
Trisomy 21
Most common chromosomal disorder

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22
Q

What race is most likely to have down syndrome?

A

Caucasians > African Americans

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23
Q

What causes DS?

A

Unknown.
Genetic predisposition
47 chromosomes instead of 46.

24
Q

How is DS usually identified?

A

At birth based on physical characteristics.

25
Q

What test must confirm DS?

A

Chromosome analysis

26
Q

What are some physical symptoms of DS?

A 
Eyes slanted upward and outward
Inner epicanthal folds
Small nose
Depressed nasal bridge
High arched palate
Excess neck skin
Wide space between big and 2nd toe
Abnormal creases
Hyperflexibiltiy and muscle weakness
27
Q

Name 8 problems associated with DS?

A

1) Cognitive impairment
2) Congenital heart malformations
3) Respiratory Infections
4) Muscle weakness
5) Immune system dysfunction
6) Congenital hypothyroidism
7) Increased risk of leukemia
8) Early onset dementia

28
Q

In a suspect DS infant, what is the first assessment a nurse must do?

A

Congenital heart Malformations

Echo test needed.

29
Q

Why do DS infants have a high risk of Respiratory infection?

A

Muscle weakness causses pneumonia easily.

30
Q

B/c of muscle weakness, what must the nurse do to prevent the infant from flopping?

A

Swaddle the infant and explain importance to mother.

31
Q

What are some support measures for DS infants?

A

Physical care, speech care, routine monitoring

32
Q

What is atlantoaxial instability? What clients are most likely to have this issue?

A

Atlantoaxial instability is excessive movement between C1 and C2. DS patients are most likely to have problem.

33
Q

What is some nursing alerts to atlantoaxial instability?

A

persistent neck pain, loss of est. motor skills, bladder, bowel control
changes in sensation.

34
Q

What is a major risk of atlantoaxial instability?

A

Risk for spinal cord compression

35
Q

What is Autistic Spectrum Disorder?

A

It is a neurologic disorder. Brains are a little bit different.

36
Q

What is a common symptom of autism?

A

Social impairment, repetitive stereotypical impairment

37
Q

Artistic symptoms being between ages ___ to ___ years

A

2-4 years

38
Q

What is echolalia?

A

A common symptom of autism. It is the act of repeating words spoken by others. Copy cat.

39
Q

What causes Autism?

A

Unknown.
Theory: Genetic/virus combination.
Probably multiple biological causes.

40
Q

Do vaccines cause Autism?

A

NO!

41
Q

What are some common symptoms of autism?

A 
Inability to maintain eye contact
Limited functional play 
Stereotyped motor behaviors 
50-70% have some degree of CI
Speech and language delays are common
Some children may excel in particular areas
42
Q

What is the prognosis of autism?

A

Usually severely disabling
Some require life-long supervision
Parental support

43
Q

What are some nursing interventions for autism?

A

Structured environment
Consistant and individualized care
Identify desired behaviors and reward
Encourage verbal communication

44
Q

What does ADHD stand for?

A

Attention Deficit Hyperactivity Disorder

45
Q

What is ADHS?

A

Inappropriate degrees of inattention, impulsiveness and hyperactivity in at least 2 settings with symptoms appearing before the age of 7

46
Q

What are symptoms of ADHD in mainly girls?

A

Inattention

47
Q

What are the 3 main symptoms of ADHD?

A

1) Inattention
2) Hyperactivity
3) Impulsiveness

48
Q

What is the most common Pharmacologic Therapy for ADHD?

A

Stimulants are most common.

  • Methylphenidate: Ritalin, Metadate, Concerta, Daytrana ,
  • Dextroamphetamines: Dexedrine
  • Mixed amphetamine salts: Adderall
49
Q

What are some nonpharmalogical treatments for ADHD?

A 
Environmental manipulation: 
Decrease stimulation and distractions
	Reduce alternatives 
	Consistent routines
	Positive reinforcement.
50
Q

What are some SE’s of Ritalin?

A

insomnia, weight loss, HA, tics

51
Q

Does longterm use of Ritalin affect adult height

A

NO

52
Q

What is Oppositional Defiant Disorder?

A

Recurrent pattern of antisocial behaviors.

53
Q

What are some behaviors of Oppositional Defiant Disorder?

A 
Negativity
Disobedience
Hostility
Defiant behaviors
Stubborn
Argues a lot
Test limits
Will not compromise
Does not accept responsibility
54
Q

Who can be diagnosed with ODD?

A

Must be less than 18 years of age.

55
Q

What are some causes of conduct disorder?

A

parental neglect, inconsistent parenting, history of abuse, lack of supervision, large family, delinquent peer group, parental psych history

56
Q

What are some behaviors of conduct disorder?

A

aggression
destruction of property
lying and stealing
serious violation of rules

57
Q

What are some intervention for ODD and CD?

A 
Be calm and firm, respectful when communicating
Model what is appropriate
Set clear limits and be consistent
Focus on strengths, not just problems
Provide a safe environment
Help develop effective coping methods
Therapy and medications

Maternal Child Nursing (Exam 1) (11 decks)

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