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SHERPATH: DEVELOPMENTAL
DISABILITY
The,student,nurse,states,,"My,sister,was,so,worried,that,her,baby,might,be,born,with,an,int ellectual,disability.,She,was,born,healthy.,I,am,so,excited,that,intellectual,disability,is,not,ev en,possible,anymore.",How,should,the,nurse,respond,to,this,statement?,-,ans- ✔✔"Childhood,conditions,and,environmental,problems,can,cause,intellectual,disability.,Le t's,talk,about,ways,to,prevent,these,from,causing,intellectual,disability." The,nurse,needs,to,clarify,that,intellectual,disability,can,still,be,diagnosed,after,birth,and,th at,there,are,ways,to,help,prevent,diseases,and,environmental,problems,from,affecting,chil dren. The,nurse,is,assessing,a,3-year- old,child,for,an,intellectual,disability.,What,questions,should,the,nurse,ask,the,parent(s)?,-, ans-✔✔"Does,your,child,have,a,seizure,disorder?" Seizure,disorders,often,develop,in,children,with,intellectual,disability,,so,the,presence,of,a, seizure,disorder,could,indicate,the,presence,of,an,intellectual,disability,along,with,other,sig ns,and,symptoms. "Can,your,child,understand,simple,directions?" A,child,with,intellectual,disability,does,not,have,age-appropriate,cognitive,skills.,A,3-year- old,child,should,be,able,to,follow,a,simple,direction,,so,the,inability,to,do,so,indicates,a,pote ntial,problem. "Is,your,child,developing,as,you,would,expect?" This,question,allows,the,parents,to,bring,up,any,concerns,about,the,child's,development,,w hich,will,help,the,nurse,gather,information. "Is,your,child,able,to,verbally,communicate,needs?" Communication,is,a,developmental,milestone,that,is,often,delayed,in,a,child,with,an,intelle ctual,disability.
A,parent,of,two,children,,including,a,girl,with,an,intellectual,disability,states,,"I,have,a,hard,ti me,working,with,my,daughter.,She,just,doesn't,seem,to,understand,what,I'm,saying,like,my ,son,does.",What,information,can,the,nurse,provide,to,help,the,parent?,-,ans- ✔✔"Let's,talk,about,how,to,use,simple,,concrete,explanations,and,incorporate,play,while,y ou,are,teaching,her,something,new." A,child,with,intellectual,disability,will,do,best,with,simple,,concrete,,solution- focused,information,and,will,learn,best,through,therapeutic,play,and,demonstrations.,The, nurse,should,provide,this,information,to,the,parent,to,promote,effective,communication. The,parents,of,a,preschooler,with,intellectual,disability,are,in,the,health,care,provider's,offi ce.,The,parents,seem,anxious,,disheveled,,and,tired.,What,can,the,nurse,do,to,be,most,eff ective,when,working,with,this,family?,-,ans-✔✔-- Bring,up,the,aspects,of,caring,for,the,preschooler,that,the,parents,are,doing,well. Positive,reinforcement,for,the,parents,can,help,increase,their,self- confidence,and,also,shows,that,the,nurse,is,listening,,which,can,help,facilitate,a,therapeuti c,relationship. --Provide,information,about,local,support,groups,for,parents,of,children,with,disabilities. The,parents,may,not,choose,to,attend,meetings,of,the,support,group,,but,the,nurse,should, recognize,that,the,parents,might,benefit,from,additional,community,resources,and,should, provide,this,information. -- Ask,the,parents,about,their,ability,to,maintain,other,roles,,such,as,that,of,an,employee,or,a, significant,other. Assessing,how,the,parents,are,doing,in,their,other,roles,helps,the,nurse,to,gather,informati on,about,coping,and,recognizes,the,parents,as,individuals,,as,well,as,caregivers. The,parent,of,a,child,with,autism,spectrum,disorder, (ASD),states,,"I,knew,that,I,should,not,have,allowed,her,to,get,her,vaccinations.,If,I,had,liste ned,to,my,sister,,this,never,would,have,happened.",How,can,the,nurse,appropriately,respo nd,to,this,statement?,-,ans- ✔✔"Although,many,people,think,that,vaccinations,are,linked,to,ASD,,the,research,has,not, shown,that,there,is,a,correlation,between,the,development,of,ASD,and,receiving,vaccines. " The,research,does,not,show,a,correlation,between,ASD,and,vaccinations,,so,this,is,a,true, statement.,The,research,that,originally,indicated,this,association,was,later,determined,to,b e,fraudulant.
While,assessing,an,infant,with,fetal,alcohol,spectrum,disorder, (FASD),,the,nurse,does,not,see,many,of,the,characteristics,that,she,expected,to,see.,What ,is,the,explanation,for,this,finding?,-,ans- ✔✔FASD,is,a,spectrum,of,disorders,,so,a,variety,of,signs,and,symptoms,is,possible. Children,will,not,all,present,the,same,way.,Some,children,will,have,mild,forms,,and,others, will,have,more,severe,forms,of,the,disorder. A,mother,of,two,is,adopting,an,infant,with,fetal,alcohol,spectrum,disorder, (FASD).,She,asks,the,nurse.,"What,can,I,expect,my,baby,to,be,like?",What,education,is,im portant,for,the,nurse,to,share?,-,ans- ✔✔"Your,new,infant,may,be,more,irritable,than,the,average,infant." The,nurse,needs,to,share,information,that,will,help,the,new,mom,prepare,for,difficulties,tha t,might,be,encountered,with,an,infant,with,FASD. "The,new,baby,is,more,likely,to,have,a,smaller,head,than,the,average,infant." Microcephaly,is,common,in,FASD. "The,infant,may,be,smaller,and,grow,at,a,slower,rate,than,your,other,children,did." The,nurse,should,mention,that,the,child,may,have,a,growth,deficiency. The,nurse,is,trying,to,feed,a,newborn,with,fetal,alcohol,spectrum,disorder, (FASD).,The,nurse,is,holding,the,baby,in,different,positions,to,promote,feeding,,but,the,ne wborn,is,still,spitting,up,the,formula.,What,should,be,the,nurse's,next,action?,-,ans- ✔✔The,nurse,should,try,only,feeding,the,infant,small,quantities,at,a,time. Decreasing,the,amount,of,each,feeding,can,help,the,infant,with,FASD,tolerate,more,food,, which,is,important. The,mother,of,a,newborn,with,fetal,alcohol,spectrum,disorder, (FASD),appears,withdrawn,and,depressed.,The,mother,does,not,often,hold,or,look,at,the,i nfant.,When,she,does,hold,the,newborn,,she,becomes,tearful.,Which,would,be,appropriate ,comments,for,the,nurse,to,make?,-,ans- ✔✔"You,appear,upset,when,you,hold,your,baby.,How,are,you,feeling?" The,nurse,should,point,out,what,is,observed,and,encourage,the,mother,to,voice,feelings,a bout,the,infant's,condition. The,parents,of,a,child,with,a,neurologic,disorder,and,severe,intellectual,disability,are,conce rned,about,the,child's,frequent,emotional,changes,and,anger.,How,might,the,nurse,interpr
et,these,changes,in,emotion?,-,ans- ✔✔The,child,may,be,frustrated,and,unable,to,appropriately,express,needs. Children,with,severe,intellectual,disability,have,limited,expressive,speech,and,limited,self- help,skills. The,nurse,received,report,about,a,child,experiencing,early,signs,of,difficulties,associated, with,mild,intellectual,disability.,What,behaviors,should,the,nurse,anticipate,from,the,child?,- ,ans-✔✔The,child,spends,time,alone,and,rarely,makes,eye,contact. Isolation,and,signs,of,low,self- esteem,are,behaviors,associated,with,mild,intellectual,disability. An,adolescent,with,moderate,intellectual,disability,states,,"I,want,to,live,on,my,own,when,I, become,an,adult.",What,is,the,nurse's,best,response?,-,ans- ✔✔"Let's,talk,about,how,we,can,work,together,to,prepare,you,for,more,independence." Supervision,and,support,that,can,be,provided,in,a,group,home,is,a,viable,option,for,someo ne,with,moderate,intellectual,disability. The,parent,of,a,child,with,intellectual,disability,states,,"I,thought,she,would,be,doing,more,b y,now.,They,said,her,condition,is,only,mild.,I,think,she,is,just,difficult,on,purpose,and,doesn' t,try.",What,should,be,the,nurse's,priority,assessment,question?,-,ans- ✔✔"What,are,your,expectations,for,your,child?" The,nurse,should,determine,whether,the,expectations,that,the,parent,has,are,realistic,and, appropriate,for,the,functional,level,of,a,child,with,mild,intellectual,disability. A,school,nurse,is,providing,education,to,a,group,of,teachers,regarding,working,with,intellec tually,disabled,school- aged,children.,What,information,is,most,important,for,the,nurse,to,emphasize?,-,ans- ✔✔Put,a,stop,sign,picture,on,any,object,or,area,that,you,do,not,want,the,children,to,touch,o r,enter. Safety,is,the,most,important,information.,Frequent,visual,reminders,should,be,provided,for, children,with,intellectual,disability. The,nurse,is,caring,for,an,adolescent,with,a,moderate,intellectual,disability.,How,should,th e,nurse,best,communicate,with,the,adolescent?,-,ans- ✔✔"The,floors,get,very,slippery,when,they,are,wet,,so,if,you,spill,or,get,water,on,the,floor,,j ust,let,me,know,,and,we,can,get,it,cleaned,up,,so,you,don't,fall." The,nurse,should,provide,safety-,and,solution- focused,information,that,is,simple,and,concrete.
year- old,sibling,to,spend,the,night,in,the,hospital.,Allowing,a,sibling,to,spend,the,night,is,against,t he,policy,of,the,hospital,unit.,Which,is,the,nurse's,best,response?,-,ans- ✔✔The,nurse,should,discuss,the,policy,with,the,parents,of,the,patient,and,develop,a,plan,t hat,meets,the,requirements,of,the,facility,and,the,needs,of,the,adolescent. The,nurse,needs,to,create,a,plan,to,help,ensure,the,safety,and,comfort,of,the,adolescent,p atient,with,ASD.,Children,and,adolescents,with,ASD,often,need,someone,,in,this,case,,the, sibling,,to,help,ensure,their,safety.,The,nurse,can,work,with,the,parents,to,safely,and,corre ctly,accomplish,this. Parents,come,to,the,clinic,with,their,infant,who,was,recently,diagnosed,with,autism,spectru m,disorder, (ASD).,The,parents,state,that,they,think,their,child,is,"just,fine.",What,questions,can,the,nur se,ask,to,assess,for,signs,of,ASD?,-,ans- ✔✔"Does,your,infant,look,at,you,when,you,speak,to,him,or,her?" The,child,with,ASD,may,not,show,interest,in,the,parents,and,may,not,show,the,early,signs, of,communication,expected. "Does,your,infant,seem,to,do,the,same,actions,over,and,over,again,with,toys?" Children,with,ASD,may,not,play,with,toys,in,a,way,that,is,expected;,they,may,engage,in,rep etitive,actions,with,toys,instead. "Has,your,child,shown,behaviors,that,indicate,that,he,or,she,misses,you,when,you,are,gon e?" Children,with,ASD,may,not,show,signs,of,attachment,to,the,caregiver,and,therefore,the,nur se,should,ask,this,type,of,question. "If,your,child,appears,distressed,,does,he,or,she,come,to,you,and,climb,on,your,lap,and,loo k,for,comfort?" Children,with,ASD,often,do,not,look,for,comfort,or,soothing,from,their,parents. The,mother,of,young,child,with,fetal,alcohol,spectrum,disorder, (FASD),asks,,"What,does,this,disorder,mean,for,my,plan,to,have,a,big,family?",What,would ,be,the,most,therapeutic,response?,-,ans- ✔✔"You,can,have,more,children.,Let's,discuss,pregnancy,planning,and,alcohol,avoidance ,in,order,to,prevent,having,another,child,with,FASD." Having,one,child,with,FASD,does,not,mean,that,the,mother,cannot,have,more,children,,but ,it,does,mean,that,the,mother,should,receive,education,to,decrease,the,likelihood,that,she, will,drink,during,future,pregnancies. The,nurse,is,assessing,an,infant,with,fetal,alcohol,spectrum,disorder, (FASD).,The,nurse,performs,a,thorough,head-to- toe,assessment.,What,is,the,primary,reason,for,this,assessment?,-,ans-
✔✔A,thorough,assessment,is,completed,because,other,abnormalities,are,often,present,in, an,infant,with,FASD. The,nurse,does,need,to,determine,whether,any,other,associated,congenital,conditions,are ,present,so,that,a,plan,of,care,can,be,designed. A,10-year-old,patient,with,a,history,of,fetal,alcohol,spectrum,disorder, (FASD),without,any,identifiable,intellectual,or,physical,impairments,comes,into,the,clinic,wi th,the,parents.,The,parents,want,to,know,what,impairments,might,be,expected,as,their,chil d,continues,to,grow.,What,information,should,the,nurse,share,with,this,family?,-,ans- ✔✔The,child,may,start,to,experience,joint,pain,or,stiffness. Joint,abnormalities,are,common,manifestations,in,a,child,with,FASD. A,child,is,brought,to,the,clinic,with,suspected,fetal,alcohol,spectrum,disorder, (FASD).,What,action,taken,by,the,nurse,will,be,a,priority,in,caring,for,this,patient,and,the,fa mily?,-,ans- ✔✔Prepare,the,family,for,the,necessity,of,a,workup,to,determine,the,symptoms,and,other,c onditions,associated,with,the,disorder. An,extensive,workup,is,needed,when,a,child,is,suspected,of,having,FASD.,The,parents,ne ed,to,be,prepared,for,the,assessments,and,testing,that,will,be,required,to,confirm,or,rule,ou t,the,diagnosis. The,nurse,is,treating,a,newborn,and,the,mother,confides,in,the,nurse,that,she,drank,alcoho l,socially,throughout,the,pregnancy.,The,nurse,should,be,careful,to,assess,for,which,specifi c,signs,and,symptoms?,-,ans-✔✔--Hypotonia Hypotonia,is,correlated,with,FASD,,which,can,result,from,maternal,alcohol,ingestion,durin g,pregnancy. --Weak,suck,with,bottle,feeds Feeding,problems,are,common,in,an,infant,with,FASD,,which,can,occur,as,a,result,of,mate rnal,alcohol,ingestion,during,pregnancy. --Head,circumference,below,target,for,age Microcephaly,is,a,common,manifestation,of,FASD. --Incessant,crying,despite,soothing,attempts Difficulty,in,soothing,the,infant,could,be,an,indication,of,FASD,,which,correlates,with,the,m other's,history,of,alcohol,ingestion,throughout,pregnancy.
