Section 4: Learning disabilities and communication Flashcards
What is a learning disability?
A learning disability is a reduced intellectual ability and difficulty with everyday activities – for example household tasks, socialising or managing money – which affects someone for their whole life.
People with a learning disability tend to take longer to learn and may need support to develop new skills, understand complicated information and interact with other people.
Is learning disability a diagnosis or disability?
Diagnosis.
Explanation: It affects how a person learns and understands.
What should not be classed as a learning disability?
Autism, ADHD, mental health, dyslexia
What is STOMP?
Stopping over use of psychotropic medication for people with Autism and learning disabilities.
What is STAMP?
Supporting treatment and appropriate medication in paediatric
What is diagnostic overshadowing?
Diagnostic overshadowing occurs when healthcare providers assumes physical ill health is the symptoms of an existing diagnosis, potentially overlooking other medical issues. E.g. a patient with mental health conditions presenting with chest pain may have their symptoms dismissed as anxiety or panic attack.
Co-morbidities of a learning disability
- Cerebral Palsy
- Autism
- Epilepsy (approx. 30%)
- Physical disabilities
- Mental Health (3X higher)
- Sensory impairments (sight, hearing, touch)
- Dysphagia
- Cardiovascular problems
- Respiratory issues
What is meant by cognitive impaiment?
It is the impairment of the mind that affects memory, attention and decision making. It can be temporary or permanent. e.g. dementia
What are the nursing care/management for LD?
Demonstrate your understanding of the co-morbidities you have listed by explaining one co morbidity and how better nursing care could reduce death within this group of patients?
Communicate with them in a way they understand such as breaking down information into small chunks using pictures.
Early investigations,
Training, awareness,
Listening, and
communication considering alternatives for this patient group,
Carers involved,
Hospital passports,
Avoiding assumptions, diagnostic overshadowing,
Time - allowing additional time,
quieter spaces,
Set reminder for their appoints
Try to minimise their waiting time during appointments
Team efforts involving family to help tailor care
What are the causes of cognitive impairment?
Brain injury
Mental health disorders
Old age
Dementia
Do we have an awareness of first aid for seizure? Give example
First be calm
remove anything dangerous around the patient
put a cushion under their head
Let the seizure run its course if it lasts 5 minutes or longer call an ambulance
After seizure roll the patient into recovery position
Do not put anything in their mouth
After the seizure the patient might be confused stay with them until they are completely aware
Uphold dignity as some patients may become incontinent during seizures
What are the 3 C’s for seizure?
Calm
Cushion
Call
What are the causes of LD?
Genetic factor
Brain injury
Brain infection - meningitis
Prenatal infection
Development of certain genes whilst unborn baby is developing
Mother using drugs and alcohol during pregnancy
What is the tool used for LD?
The IQ (intelligence quotient) tool is used to calculate the severity of support LD patients require. Ranges from mild to severe,
Alex is a 25yr old man who has complex care needs that include profound learning disability and a mental health diagnosis. He woke up with a persistent cough that has worsened over the last 3 days. His breathing has become laboured, and his chest feels tight. Despite his struggles with communication, Alex managed to convey his discomfort through gestures and distressed sounds. His caretaker, Sarah, has noticed his worsening condition and become concerned. Alex’s temperature has ‘spiked’, and he appears increasingly disoriented which is out of character for him. He has started to refuse fluids and has not passed much urine in the last 24 hours.
Alex is showing signs of what clinical condition? (1 mark)
What are two clinical indicators of this illness? (2 marks)
Alex is showing possible signs of sepsis; possibly a pneumo sepsis.
Clinical indicators of sepsis:
-Hypotension; low blood pressure
-Hypo or hyperthermia (body temperature changes),
-Tachycardia
-Increased respiratory rate (Tachypnoea),
-Low or no urine (anuria) output as condition worsens,
-Rising lactic acid. (any two will attract 2 marks, must use correct terminologies)
What can be the signs of changing health in someone who is non-verbal? ( 1 mark) From the options below choose ONE correct answer.
A. Reduced sleepiness
B. Increased urine output
C. Skin changes like a rash if there is a bacterial or viral meningitis
D. Reduced seizure frequency
C. Skin changes like a rash if there is a bacterial or viral meningitis
What is STOMP and STAMP and why is it used in the United Kingdom?
(3 marks)
Stop The Over Medication of People with Learning disability and Autistic people.
Supporting Treatment and Appropriate Medication in Paediatics.
1.To increase awareness and stop the inappropriate use of antipsychotropic medications.
2.To increase awareness and promote the correct use of anti-psychotropic medications in paediatrics.
Explain the term cognitive impairment, (3 marks) and demonstrate your understanding of this term by giving three examples of this in clinical practise and reason why this term can be interchangeable?
- Cognitive impairment is a term used to describe changes in memory, concentration, and the ability to think clearly and put thought into action.
- Being unusually disorganised. Trouble remembering facts you would usually remember such as names and dates,
- Putting a sentence together.
- Examples of this in clinical practise can be dementia, UTI or infections, trauma to the head, substance/drug use/misuse,
- Interchangeable - means that it can be short term or long term and an example is seen in patients with dementia, where this can deteriorate as the conditions progress
Potential challenges that patients with a learning disability may face if they are admitted to hospital with sepsis
- Informed Consent – Difficulty understanding medical information may impact decision-making.
- Communication Barriers – Miscommunication can lead to misunderstandings or overlooked needs.
- Assumption of Capacity – Risk of assuming lack of capacity, leading to exclusion from decisions.
- Equity in Care – Potential disparities in urgency and quality of care.
- Best Interest Decisions – Determining what is in the patient’s best interest can be complex.
- Respect for Autonomy – Balancing medical interventions with personal preferences.
- Resource Allocation – Risk of discrimination in emergency care decisions.
- Family/Carer Involvement – Ethical concerns about the role of carers in decision-making.
- Quality of Life Considerations – Sensitivity in treatment choices and perceptions of quality of life.
- Post-Hospital Care – Ensuring a safe discharge and appropriate ongoing support.
