Intellectual Disability
This is a term used when there are limits to a person's ability to learn at an expected level and function in daily life. It could also cause a child to develop more slowly than other children of the same age.
What is Intellectual Disability?
A child with a history of seizures arrives in the emergency department in status epilepticus. This action is the nursing priority.
A. Taking vital signs
B. Maintaining a patent airway
C. Establishing an IV line
D. Performing a rapid neurological assessment
What is B-priority nursing action for a pediatric patient experiencing status epilepticus is to maintain a patent airway.
This is a group of conditions that can occur in a person who was exposed to alcohol before birth. These effects can include physical problems and behavior/learning problems.
What is Fetal Alcohol Spectrum Disorder?
This is another name for a Low Profile G-tube.
What is the Mic-Key G-tube?
Name the 4 questions to determine orientation.
What is your name?
What is the date?
Where are you at this time?
Why are you here?
True or False--research suggests that nurses do not feel adequately prepared to support patients with intellectual disability.
What is True?
This type of seizure was previously referred to as petit mal, loss of consciousness lasting 5 to 10 seconds, motionless, blank stare, minimal or no change in behavior, resembles daydreaming/inattentiveness, lip smacking, twitching of eyelids/face or slight hand movements, unable to recall episodes
A. Absence seizure
B. Myoclonic seizure
C. Atonic seizure
D. tonic-clonic seizure
What is A-absence seizure
Myoclonic-symmetric or asymmetric involvement, brief contractions of muscle, can involve only the face/trunk or one or more extremities, might not lose consciousness
Atonic-known as drop attacks, muscle tone is lost for a few seconds, period of confusion follows, if seizures are frequent, child should wear a helmet
Tonic-clonic-referred as grad mal, tonic phase(10-30seconds), loss of consciousness, tonic contraction of entire body(arms flexed and legs, head and neck extended), possible piercing cry. Clonic phase(typically 30-50 seconds-can last 30 min or longer), violent jerking movements of the body, trunk/extremities experience rhythmic contractions/relaxations, can have foaming in the mouth, incontinent of urine and feces.
This is the most common chromosomal abnormality of a generalized syndrome. Trisomy 21 is seen in 92% of these cases.
What is Down Syndrome?
Elevate the HOB to this degree during feeding and for 30 to 60 minutes afterward.
What is 30-45 degrees?
Neuro exam includes a series of physical examination steps that assess nervous functioning. Name at least two.
What is mental status and speech, cranial nerves, strength/coordination/balance/movement/muscle tone, reflexes, perception of feeling in different parts of the body to different stimulation(touch, vibration), gait/mobility, spin, level of consciousness, orientation/memory
There are many signs of intellectual disability--name two.
What is sit up, crawl, walk later than other children,
-learn to talk later or have trouble speaking
-slow to master potty training, dressing and feeding themselves
-have trouble understanding social rules, seeing the results/consequences of their actins
-trouble solving problems
-behavior problems
An 8-year-old child, who is not responding to anti-seizure medications, is prescribed to start a ketogenic diet. This diet will include:
A. High carbohydrates and high fat
B. Low fat, high salt and high carbohydrates
C. High fat and low carbohydrates
D. High glucose, high fat and low carbohydrates
What is C? High fat and low carbohydrates
This is a nonprogressive impairment of motor function, especially that of muscle control, coordination and posture. Some expected findings-rigid posture/extremities, toe walking, arching back, hyperreflexia, etc.
What is Cerebral Palsy?
This type of tube feeding formulas are easier for the digestive system to digest and absorb, making them better suited for digestive problems.
A. Standard Formula
B. Elemental Formula
C. Blenderized Formula
D. Home-prepared Formula
What is B-Elemental Formula?
The nursing action is appropriate when assisting with the rapid assessment of a patient diagnosed with a neurological condition.
A. Assessing apical pulse
B. Monitoring blood pressure
C. Obtaining an oral temperature
D. Determining level of conscious
What is D---rapid neurological assessment includes level of consciousness, skin color for cyanosis and the ability to breathe effectively.
The definition of the Disabilities Education Act (IDEA)
School-age children with intellectual disabilities are eligible for special education for free through the public school system
A patient is taking Phenytoin for treatment of seizures. This statement by the patient requires to re-educate the patient about this medication.
A. "Every morning I take this medication with a full glass of milk with my breakfast."
B. "I know it is important to have my drug levels checked regularly."
C. "I will report a skin rash immediately to my doctor."
D. "This medication can lower my body's ability to clot and fight infection."
What is A--Phenytoin should NOT be taken with milk products or antacids because it affects absorption. All the other options are correct.
Psychogenic nonepileptic seizure involves attack that resemble epilepsy-related seizures that are due to underlying psychological distress, not abnormal electrical activity in your brain. Name the type of treatment for this disorder.
Cognitive Behavioral Therapy, psychotherapy (talk therapy), treating underlying psychiatric symptoms
Name two causes of blockages between medication/enteral feedings tubes..
What is interaction between feeds/medication, viscosity of liquid medication, binding of medication to the tubes, residue of tablet that has been crushed
Name the three components(responses) of the Glasgow Coma Scale.
What is the Eye opening response, Verbal response, and Motor response?
These are two ways of diagnosing Intellectual Disabilities.
-Measure a child's IQ (intelligence quotient) a normal IQ is around 100. Children with ID have a lower IQ-between 70 and 55 or lower
-Measure adaptive behavior--what the child can do in everyday functioning and compare to other children in the same age
A patient with a history of epilepsy is taking Phenytoin. The patient's morning labs are back and the patient's Phenytoin is 7mcg/ml. Based on this finding, this will be the next nursing action.
A. Assess the patient for a rash
B. Initiate seizure precautions
C. Hold the next dose of Phenytoin
D. Continue to monitor the patient
What is B--normal Phenytoin level is 10 to 20 mcg/ml. The patient's level is low; therefore, the patient is at risk for seizure. The nurse should initiate seizure precautions. Remember a patient being under medicated is a trigger for developing a seizure.
This syndrome is an inherited condition caused by a change in the genetic material found in every cell of the body. It affects both males and female(females often have milder symptoms than males) Some physical features--a large head, long face, prominent ears/chin/forehead, flat feet, etc.
What is Fragile X Syndrome?
Name Two nursing responsibilities for a patient with a PEG tube.
What is assessing tube placement, maintaining patency of the tube, assessment of skin integrity surrounding the tube, daily cleansing of the tube insertion site, assessing bowel sounds, assessing abdomen(distention), assessing gastric residual, elevating the HOB, monitoring intake/output, monitoring weight, etc.
Name the test to check the electrical function of your brain by placing electrodes on the scalp. This test can help the healthcare provider diagnose and monitor brain related conditions like epilepsy.
What is Electroencephalogram (EEG)?