Week 13 Notes - ADHD, Autism, Down’s Syndrome, Cognitive Impairment and Drowning ATI Ch. 15 PDF

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ADHD, Autism, Down’s Syndrome, Cognitive Impairment and Drowning
ATI Ch. 15 & 44...

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Week 13 ADHD, Autism, Down’s Syndrome, Cognitive Impairment and Drowning Ch 16 & 18 ATI Ch 15 & 44 Attention-Deficit/Hyperactivity Disorder and Learning Disability or ADHD What causes it? Underlying cause is unknown, some studies think it comes from altered neurotransmitters; deficit for right hemisphere What to look for? Children may exhibit behaviors and difficulty climbing and running, talking excessively, cannot finish school work or activity, does not listen, will have hyperactivity, impulsivity, interrupting What tests tell you? Diagnose by doing a complete and thorough observation, with pediatric, family, psychologist, teacher, administrators How to treat it Medical management, behavior modification, focusing on family and strengths in family, modify child’s environment, assist with classroom placement and pharmacology aspect A child in a classroom is disruptive with loud talking, has a short attention span and has difficulty organizing work. What is the most likely diagnosis for this child? 1. Enuresis (bed wetting) 2. Sexual Abuse 3. Learning Disability 4. Attention deficit-hyperactivity disorder Autism Spectrum Disorders (ASDs) - Definition—Complex neurobiological and developmental disabilities that typically appear during the first three years of life. - Cause—unknown - there is no connection to autism and vaccines such as MMR and tDap Clinical Manifestations - Core deficits—social interactions, communication and behavior - Unusual attachments to objects - Likes to be alone - IQ less than 70% - Uses gestures instead of words - Lack of empathy Diagnostic Evaluation - Two ASD screenings at age 18 and 24 months using a valid screening tool. - Checklist for Autism in Toddlers (CHAT) - Pervasive Developmental Disorders Screening Test Treatment/Nursing Care - ASD-lifelong condition - Early recognition

- Highly structured and intensive behavior modification programs - Positive reinforcement - Teach verbal communication skills - Encourage support groups and provide outside resources - Medications—based on an individual basis Cognitive Impairment - Cognitive Impairment is a general term that encompasses any type of intellectual disability. The term intellectual disability (formerly mental retardation) has become the most used term internationally. - Cognitive Impairment is characterized by significant limitations in intellectual functioning and impairment in several different adaptive areas: - Communication - Self-care - Home living - Social skills - Health and safety - Self directions - Functional academics - Community use - Work - Lifelong learning What to look for? Primarily genetic, biochemical and infections; CI IQ range from mild 50-70 or less than 20 for some IQs; early signs are gross and fine motor delay, Downs Syndrome, irritability, nonresponsive syndrome to the environment, major organ dysfunction, language delay, behavior difficulties What test tell you? DSM-5 is how they diagnose Treatment Typically done by early intervention, care is individualized; PT/OT/speech referrals Down’s Syndrome - Trisomy 21 in 97% of cases - Most common genetic disorder Characteristics of a Down’s Child - Flat broad forehead - Flat nasal bridge - Protruding tongue - Small head - Upward outward slanting eyes - Small ears-which maybe low set - Low muscle tone - Transverse palmer crease - Loose joints making them very flexible

Diagnostic Procedures Treatment Client Education The nurse is assessing a neonate who was born 1 hour ago to healthy Caucasian parents in their early 40s. Which of the following findings would be most suggestive of Down Syndrome A. Hypertonia B. Inner epicanthal folds C. Low-set ears D. Long, thin fingers and toes Drowning - Drowning refers to an event in which a child’s airway is submerged in liquid, leading to an impairment to breathing. - The outcome can be fatal or non-fatal with some non-fatal drowning events leading to significant neurological damage - Near drowning - Dry drowning - Delayed drowning Common Drowning Dangers - Bathtub, Shower - Sink - Buckets, Coolers - Backyard pool - Hot Tub - Wading pool Drowning/Assessment/Diagnostic Test - History, Time and location of submersion - Type and temperature of water - Assess respirations - Assess body temperature (expect hypothermia) - Assess for other injuries such as bruising and spinal cord injury Diagnostic Tests - Labs - ABG, Electrolytes and CBC - Chest-x-rays - UA Nursing Interventions/Family Education - Nursing care is based on degree of cerebral insult - Monitor for complications that can occur 24 hrs after incident (cerebral edema, resp. distress) - Keep family informed and use a calm approach - Education-Lock bathrooms and keep toilet seats down - Do not leave your child unattended near water such as tubs, pools - Educate families that a small amount of water is dangerous -1 in deep - Swimming lessons and life jackets...