Child And Adolescent With Special Needs

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Congenital

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Present at birth

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If a congenital defect or disorder results from a defective gene, it's then

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Hereditary or genetic

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A congenital disorder is considered ___if it results from maternal factors or conditions during pregnancy or childbirth

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Acquired

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_ is the study of heredity

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Genetics

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A__is a physical or mental abnormality resulting from a defect in genetic structure.

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Genetic disorder

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A familial genetic gene means...

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The biological parent has the defective gene, and passes it on to the offspring

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Examples of genetic disorders

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Neurofibromatosis, Tay-Sachs, cystic fibrosis

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Characterized by cafe au lait spots and benign tumors. The child has neurologic, cognitive, and speech impairment. ADHD and seizures are common

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Neurofibromatosis

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An unborn error of metabolism primarily affecting children of Ashkenazi Jewish descent. The child becomes hypotonic and loses vision. Death normally occurs before 4 years. A blood test is available to determine carriers.

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Tay-Sachs diseasedisease

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____test is performed on amniotic fluid or serum, increased levels indicate possible neural tube or ventral wall defects.

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Alpha fetoprotein, AFP

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_ is available for people who are seeking information about the possibility of genetic disorders in their families

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Genetic counseling

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T or F

The genetic counselor does not make decisions for people about family planning.

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true

The counselor provides info and options, and the person or couple makes the decisions.

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Genetic counseling is a form of __ that strives to prevent birth defects

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Preventive medicine

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__are substances that the pregnant woman uses or comes into contact with! which are know to cause a wide range of fetal abnormalities.

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Teratogens

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__is a general term that describes the wide range of physical, mental! behavioral, and/or learning disabilities known to be directly related to maternal alcohol consumption

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Fetal alcohol spectrum disorders (FASDs)

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_the most severe form of FASDs

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FAS fetal alcohol syndrome

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Infants may not have all of the typical diagnostic features of FAS, but they do have some degree of functional or mental health problem

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ARND alcohol-related neurodevelopmental disorder

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have birth defects that involve the heart, kidneys, bones, and/or hearing

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ARBD alcohol-related birth defects

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microcephaly, retardation, growth deficiency shortened attention span are just a few characteristics of a child with___

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FAS or FASD

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narcotic use during pregnancy can cause the child to have ___

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neonatal abstinence syndrome

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s/s of neonatal abstinence syndrome

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irritability, tremors, hyperactive moro reflex, and poor feeding

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withdrawal for a neonate from narcotics depends on the drug used, but typically last ___

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from 24 to 48 hours after birth and lasting about 2wks

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The use of __(drug) by HIV positive pregnant women and their newborns has resulted in fewer cases of pediatic HIV and the subsequent reduction of cases of AIDS.

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zidovudine (AZT, Retrovir)

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Because of their immature immunie system, infants with HIV are diagnosed with AIDs by age __.

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4

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What are the 2 test used to confirm HIV/AIDS

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Elisa (enzyme-linked immunosorbent assay) test and the Western Blot test

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How long is zidovudine (AZT Retrovir) cont'd in the infants of women diagosed with HIV/AIDs

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one year

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T or F

Breast feeding is ok in HIV-infected mothers

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False

breast feeding is contraindicated

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What are the 2 test that are used to determine degrees of intellectual impairment?

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Weschsler Intelligence Scale for children-revised and the Stanford Binet

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___ is the numerical baseline for normal IQ

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100

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__results from a chromosomal abnormaility. It is also know as trisomy 21.

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Down Syndrome

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___is the most common cause of mental retardation

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Down syndrome

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Down syndrome in children born to mothers who are ___

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OVER 35 and mothers who smoke during pregnancy

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What are typical characteristics of babies with down syndrome?

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small, flat nose and upward, outwad lanting eyes; simian line; short square hands; short stubby feet with a space between the big toe and rest of the toes; brushfield's spots.

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What is simian line?

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an abnormal crease stright across the palms of the hand

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What are brushfields's spots?

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white dots on the irises of the eye

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a genetic, sex-linked abnormaility of the x chromosome

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Fragile X syndrome

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__ is the most common form of inherited mental retardation

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Fragile X syndrome

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What are some of the physical characteristics of a child with Fragile X syndrome?

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Large feature-broad nose, large head, wide set eyes

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How is Fragile X treated?

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no cure exist. treatment is symptomatic

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are assorted groups of chronic physical, cognitive, psychological, sensory, and speech impairments that are diagnosed at any time from the age of early development to 22yrs of age

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Developmental disabilities (DD)

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_ are educational concerns

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SLDs

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is one the most common SLD disorder where the person has difficulty with reading, spelling, or writing words. Often the person reverses letters and numbers

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dyslexia

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is the most common child behavioral disorder. It involves a learning disability and a behavioral disorder.

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ADHD or ADD

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ADHD is more common in ___ and tends to run in familiess.

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boys

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The current drug of choice for ADHD pt is____ which is a CNS stimulant that affects mental, rather than motor skills.

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Ritalin (methylpheniadate HCL)

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The __ of a child on Ritlan should measured frequently and reported immediately if failure to gain in any area.

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height and weight

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is an inherited, neurologic disorder of unknown cause, although a chemical neurotransmitter abnormality is found. children exhibit multiple involuntary movements and uncontollable vocalizations, called tics.

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Tourette Syndrome

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coprolalia

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utter obscenities (tourette)

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echolalia

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repeat words of other people (tourette)

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a group of symptoms; lifelong, complex developmental deisorders characterized by intellectual, social, and communications deficits.

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autism spectrum disorders

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autistic savant

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autistic children that exhibit a profound ability in a certain area

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eating nonfood items is termed

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pica

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__is the most sever complications of lead poisoning.

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lead encephalopathy

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some
S/S of plumbism

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blue or blue-black line on the gums near the teeth; hyperirritability; ataxia (unsteady gait); intermittent colic; nausea and vomiting

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What test is used to diagnose plumbism?

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BLL- blood lead levels

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is the administration of medications that bind to lead to remove it from the body

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chelation

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BAL in Oil

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metal antagonist dimercprol given deep intramuscularly to remove lead from the body

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a general term used to describe movement and coordination disorders in children that are the result of some form of brain damage.

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Cerebral Palsy (CP)

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T or F

Cerebral Palsy is a progressive disease

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False, It's not

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__ in the postnatal period due to high levels of bilirubin can cause Cerebral Palsy.

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Severe Jaundice or kernicterus

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the most common CP.

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spastic cerebral palsy

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is the most common degenerative muscular disorder in children. one group of x-linked, genetically transmitted disorders affecting boys characterized by progressive atrophy of symmetrical groups of skeletal muscles

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Duchenne Muscular dystrophy

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Duchenne Muscular dystrophy has a lack of what protein__in the muscles result in progressive wasting with gradual loss of strength and increasing muscle deformities.

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dystophin

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s/s of duchenne muscular dystrophy

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gower's sign, gait with a waddle, child may walk on toes, gradual muscle atrophy. the child is in a wheel chair by age 11 or 12

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what is gower's sign

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the child gets up by pushing to an upright position, using hands to climb up the legs to standing position.

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dysfluency

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is an interruption in the natural flow of speaking. EX stuttering

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the term given to thoughts or ideas of sicide.

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suicidal ideation

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an attempt at inflicting personal injury; the injury is not intended to cause death.

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suicide gesture

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what is a nursing consideration that can be used when caring for a child with suicidal ideation or gesture

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a no suicide contract where they agree to not attempt suicide for a period of time and will contact help.

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a lose of contact with reality. sometimes results from a dudden, severe emotional experience, or sometimes from the person's inability to adjust to the enviornment

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schizophrenia

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a term given to inhaling chemicals that produce a feeling od delirium or high

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huffing