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41 Cards in this Set

  • Front
  • Back
Prenatal factors that contribute to congenital anomalies.
1. Chromosomal abnormalities.
2. Intrauterine environmental factors.
3. Correlation between SGA infant and congenital anomalies.
Major reactions of and effects on the family.
1. Crisis of losing a perfect child.
2. Task of adjusting to and accepting child and his condition.
Stages of Adaptation.
1. Shock and Denial
2. Adjustment (guilt and anger)
3. Reintegration and acceptance.
Stages of Adaptation.
Shock and Denial
Mechanism that allow individuals to distance themselves from onslaught of tremendous emotional impact and to collect and mobilize energies toward goal-directed, problem-solving behaviors.
Denial allows individuals to maintain hope in face of overwhelming odds.
Stages of Adaptation.
Adjustment (Guild and Anger)
Open admission that condition exists. May experience "chronic sorrow".
gradual acceptance.
Stages of Adaptation.
Reintegration and acceptance
Incresed comfort with everyday livign. "A New Normal"
Parent Response
REactions depend on type and severity of defect.
Threat to survival (life-threatening)
Previous Experience
Marital Harmony
Child Response
Depends on age of onset of problem: the earlier the onset, the better the child is able to adapt to it.
Depends on developmental level and available coping mechanisms. Children with more severe disorders often cope better than those with milder disorders.
Influenced by significant others.
Sibling Response
lives most affected in terms of parent-child relationship.
Feel abondoned.
Nursing Diagnoses for Family
Aletered Family Processes.
Anticipatory grieving.
Impaired social interaction
Knowledge deficit
Nursing Interventions
Goal: Help family remain healty and functioning at maximum levels throughout child's life or beyond, if child dies.
Assess comping mechanisms an dsupport system
Provide support at time of diagnosis
Educate Family
Accept family's emotional reaction.
Help family to perceive the child as a child first, then as an individual with unique needs.
Promote normal development.
Establish realistic future goals.
Provide support at time of death, if child dies.
Mental Retardation
Definition: Significant subaverage general intellectual functioning existing concurrently with deficits in adaptive behavior and manifested during developmental period (between conception and 18th birthday)
Mental Retardation Causes
Genetic biochemical, viral and developmental events.
Infection and intoxication
Trauma or physical agent
Gross postnatal brain disease
Unknown prenatal influences
Gestational disorders
Psychiatric disorders
Environmental influences
Chromosomal abnormaliities
Mental Retardation Classifications:
50-55 to 70
Mental Retardation Classifications:
35-40 to 50-55
Mental Retardation Classifications:
20-25 to 35-40
Mental Retardation Classifications:
Below 20-25
Down Syndrome
Most common chromosomal abnormality of generalized syndrome.
Trisomy 21.
Risk increase with maternal age.
Prenatal diagnosis iwth amniocentisis/chorionic villi sampling
Down Syndrome Characteristics
Broad nose
Large thick tongue
Lack of fold in eyelids
Large thick tongue
Stubby fingers
Broad, short skull.
Hand and foot abnormalities
Increased respiratory difficulty.
Congenital heart defects.
Varying degrees of mental retardation.
Dwon Syndrome Clinical Features
Developmental milestone delay
Oral motor/feeding problems.
Sensory deficits
Problem with balance and mobility.
Nursing Care for Menatlly Retarded Child
Developmental assessment (developmental age vs chronologic age)
Promotion of optimum development
Help family to set limits that are simple consistently applied and appropriate for developmental age.
May need special devices
Hospitalized Mentally Retarded Child
Prepare for procedures according to developmental age.
Find out routines, security items, behaviors that may require intervention.
Learning Disability
Term used to define a group of disorders manifested by significant difficulties in acquistion and use of
Mathematic abilities
social skills
Children with a learning disablity are often very bright.
Attention Deficit Hyperactivity Disorder (ADHD)
Child displays behavior that is not unusual child behavior- difference is in quality of motor activity and develomentally inapproprieate inattention, impulsivity and hyperactivity.
Attention Control Systems of the Human Mind
Processing Control
The mind's way of controlling information coming in (occurs in diverse and diffuse sites in the brain)
Attention Control Systems of the Human Mind
Mental Energy Control
The mind's way of controlling the flow of "fuel" for concentrating and acting right (brainstem)
Attention Control Systems of the Human Mind
Production Control
The mind's way of controlling its output - what it gets done- when and how (frontal lobe)
ADHD Managing
1 Medication: Psycho-stimulants (Ex. Ritalin, Dexedrine- long-term use may lead to growth suppression)
2 Environnment: Stable, predictable, regular routines.
3 Uncovering strengths is an important as exposuer of dysfunctions.
4 Assessment recurring themes (no one source of observations should be conclusively interpreted without multiple other corroborating evidence-combination of testing and professional consultations).
5 Multi-faceted approach to management
Failure to Thrive (FTT)
Causes of Organic
Prenatal events disorders of central nervous system gastrointestinal system, renal system, heart, endocrine system, chromosomal disorders, chronic infection, cystic fibrosis, idiopathic short stature.
Clinical Manifestation of NonOrganic FTT
Usually child less than 2 years
Weight below 5th percentile
No evidence of systemic disease or abnormality
Developmental retardation
Most often result of psychosocial factors:
Inadequate nutritional info
Deficiency in Maternal Care
Disturbance in maternal child attachment
Distrubance in child's ability to separate from the parent- food refusal to maintain attention
Factors related to inadequate feeding:
Health Beliefs
Inadequate Nutritional Info
Family Stress
Feeding Resistance
Insufficient Breast Milk
Characteristics of Infant
Intense interens in inanimate objects
Much less interested in social interaction
Vigilant of people at a distance; increasingly distressed as they come closer.
Dislike being touched or held in face to face contact
History of difficult feedin, vomitting, sleep distrubances, excessive irritability
Demonstrate habit patterns
Irregularity in ADLs
"Difficult" temperament or passive, sleepy, lethargic infant
Degree of "fit" biggest issue
Characteristics of Parent
Isolation/Social Crisis
Inadequate support system
Poor parenting as a child
Lack of education
Physical and mental health problems
Lack of commitment to parenting
Nursing Diagnosis for FTT Child/Parent
Altered Nutrition
Altered Nutrition
Consistent care of staff to feed child
Quiet unstimulating environment
calm,even temperament while feeding
Gives directions about eating
Structured Routine
Maintain face to fc posture
be calm and persistent through 10-15 minutes of food refusal
avoid force feeding
introduce new food slowly
follow child's rhythm of feeding
Nursing Diagnosis for FTT Child/Parent
Altered Growth and Development
appropriate developmental stimulation
Nursing Diagnosis for FTT Child/Parent
Altered parenting
Increase self-esteem
develop rapport teach infant care
explain cues of child
allow them to gradually assume care
praise and encourage
Definitions of Child Abuse (SC LAW)
Physical Child Abuse: An inappropriate use of force against a child. Any nonaccidental form of injury or harm inflicted on a child (Under 18) by a parent or caregiver
Child Neglect
Family conditions which are assumed to be detrimental to the child's health, safety, physical and psychosocial development. It is further assumed that parents or caregivers have some control over these conditions.
Lack of supervision, adequate clothing and hygiene, medical dental care, education, nutrition, shelter.
Sexual Abuse
Perpetrated by a member of the child's family group and includes not only sexual intercourse but also any act designe to stimulate a child sexuality or to use the child for sexual stimulation for either the perpetrator or another person.