A young child recently diagnosed with terminal cancer just told the nurse "I have a secret to tell
you, but don't tell mommy and daddy. I'm going to die". The parents don't want to tell the child
that he is near death. What do you need to start talking to the parents about? - ANS Discuss a
good death- home or hospital, drugs for treatment or for pain relief?
What IQ constitutes cognitive impairment? - ANS <70-75
When is cognitive impairment diagnosis made? - ANS Before 18 years old
What is the most common chromosomal abnormality? - ANS Down syndrome
What one maternal cause can increase the risk for having a Downs baby? - ANS Having her
baby >40 years old
What is the most common inherited cause of cognitive impairment? - ANS Fragile X Syndrome
The triage nurse said that she is sending back a Fragile X patient. What do you expected to
see? Hear? Find? - ANS See- strabismus, long narrow face with large jaw, big ears, big head,
very large testes
Hear- Possible mitral valve prolapse, speech problems
Find- Attention deficit, autistic like, cognitive impairment, possible violence
What hospital cause greatly increases the likelyhood of an infant developing hearing loss? -
ANS Them being in the NICU (lots of noise)
What are some causes for hearing impairment? - ANS Chronic ear infection
Perinatal infection
NICU stay
Aanatomic malformation
Asphyxia or prolonged oxygen supplementation
Maternal substance abuse
How to treat conductive hearing loss? - ANS Antibiotics
Tympanoplasty
Hearing aids
How to treat sensorineural hearing loss? - ANS Cochlear implants
, When is it best to get a Cochlear implant? Why? - ANS Before 1 year old so the child can learn
sounds better and learn as he grows instead of having to relearn and getting frustrated
What kind of visual impairment is normal until age 7? - ANS Hyperopia (farsightedness)
How do you treat amblyopia (lazy eye)? Strabismus? - ANS Eye patch on the good eye
Possible surgical repair
How many kinds of autism are there? What are they? - ANS Two
social communication/interaction
Unusually repetitive behavior/interest in certain activities
Do genetics play a role in autism? - ANS Highly probable
What is one of the biggest life changing things for kids with cognitive impairment? - ANS Early
diagnosis and intervention
What condition used to be blamed on delivery doctors? - ANS Cerebral Palsy
What is the cause of most cerebral palsy? - ANS Unknown prenatal causes
What is one major complication of cerebral palsy that happens in 10-15% of the children with
this condition? - ANS Epilepsy
What is an intrathecal pump? Who is it used for? - ANS A pump inserted into the intrathecal
space for cerebral palsy kids
What medication is in an intrathecal pump? What does it do? - ANS Baclofen, it reduces
spasticity in cerebral palsy children
What is the most common defect of the CNS? - ANS Spina bifida
How do you prevent neural tube defects? - ANS Folic acid
What is myelomeningocele? - ANS A form of spina bifida where the spine doesn't fully form
correctly and the spinal cord protrudes from the back when the baby is born
What is the treatment for myelomeningocele? - ANS Surgery before or very shortly after birth
If after: Keep the baby NPO until surgery, keep the baby prone, Give pacifier for sucking needs
and IV fluids for hydration
What is a common surgery, especially for girls, with spina bifida? - ANS Urinary diversion
What are the four types of spinal muscular atrophy? - ANS 1- non-sitters
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