Intellectual Disability nursing

Question 1

What do we mean by “intellectual disbaility”

Answer 1

significantly subaverage general intellectual functioning acompanied by significant limitations in adaptive functioning in at least 2 of the following areas.

• communication
• self care
• home living
• social/ interpersonal skills
• use of community resources
• self direction
• academic skills
• lesure

Question 2

what are the four sub-average intellectual functioning IQ levels?

Answer 2

• mild 50-69
• moderate 35-49
• severe 20-34
• profound below 20

Question 3

is it all about the persons IQ?

Answer 3

diminishment of adaptive behaviour, assessment is according to levels of support needed and these can be labeled as intermittent

Question 4

what else is measured

Answer 4

• assistance with budgeting, meal planning, limited social/ work skills but requires frequent support with supervision and budgeting and living assistance
• extensive (can perform tasks with assistance but not independently) or pervasive unable to perform day to day functions full assistance

Question 5

why do people with intellectual disabilities have higher rates of mental illness

Answer 5

• limitations affecting communication abilities, processing skills, cognitive functioning and social skills
• consider recovery principles strengths hope and resilience many people with ID for whatever reason, may not have these attributes

Question 6

can people with an intellectual disability presenting with a mental illness be placed unt the mental health act

Answer 6

yes, because the MHA works to assist people to manage their mental disorder and as people with ID are just as susceptible to MI then they are afforded the same rights as any other citizen accessing health care

Question 7

what communication factors does the nurse have to consider when assessing someone with an ID for both physical and mental health

Answer 7

• limited capacity for conversation, primary disability, hearing, speech impediments
• problems generalising speech and will seek familiar contexts such as home e.i. voices come from TV
• shyness and confusion, use repetitive (ecnolotic) speech
• acquiescence, says yes to please

Question 8

Who would you involve in an assessment

Answer 8

• everyone you can

Question 9

JOMACC assessment J Judgement

Answer 9

behavior that assesses impaired judgement such as perception of events, appropriate situations (stranger danger). Aggression, responses to significant life events (death can be confusing) no improvement in behaviour despite input

Question 10

JOMACC assessment O orientation

Answer 10

awareness of surroundings name, reason for admission

Question 11

JOMACC assessment M memory

Answer 11

recent. remote and immediate recall

Question 12

JOMACC assessment A affect

Answer 12

emotional status, acting out behaviour and reluctant to engage in activities or be with people, changes in facial attitudes to events, body language, changes in functioning such as sleep, appetite, loss of interest, change in behaviour/ mood that occurs in all settings

Question 13

JOMACC assessment A attitude

Answer 13

uncooperative and unfeeling

Question 14

JOMACC assessment C cognition

Answer 14

understanding, speech (though form) decreased ability to perform ADL’s, hallucinations (voices ect) emotional, dissociation, paranoid behaviour, distortion and false beliefs

Question 15

Define the term diagnostic overshadowing

Answer 15

Attributed behaviours solely to the ID or without looking for other underlying causes for example aggressive behaviour is because they don’t understand rather than considering reasons for behaviour such as pain, anxiety or mood fluctuation

Question 16

What implications can diagnostic overshadowing have for planning and implementing care?

Answer 16

poorly deserved care planning not addressing the underlying problem