Ch. 29: Down Syndrome

Question 1

What kind of abnormality is down syndrome?

Answer 1

Chromosomal abnormality

Question 2

What is a risk factor for down syndrome?

Answer 2

Maternal age greater than 35

Question 3

How is their head?

Answer 3

• Separated sagittal suture
• Enlarged anterior fontanel
• Small round head
• Flattened forehead

Question 4

How are their eyes?

Answer 4

Upward, outward slant to eyes

Question 5

How is their nose?

Answer 5

Small nose with depressed nasal bridge

Question 6

How are their ears?

Answer 6

Small ears with short pinna

Question 7

How is their mouth?

Answer 7

• High arched narrow palate

- Protruding tonuge

Question 8

How is their neck?

Answer 8

Short, broad neck

Question 9

How is their rib cage?

Answer 9

Shortened rib cage

Question 10

Any heart problems?

Answer 10

Possible congenital heart defect

Question 11

How is abdomen?

Answer 11

Protruding

Question 12

How are feet and hands?

Answer 12

Broad, short feet and hands with stubby toes and fingers

Question 13

Down syndrome children have a _____ palmar crease

Answer 13

Transverse palmar crease with a large space between big and second toes with plantar crease

Question 14

How is their stature?

Answer 14

Short

Question 15

What kind of flexibility?

Answer 15

Hyperflexibility and hypotonia

Question 16

How can DS be tested in prenatal?

Answer 16

Testing for alpha-fetoprotein in maternal serum

Question 17

How can DS be tested in an infant?

Answer 17

Chromosome analysis and echocardiography

Question 18

What kind of surgical interventions can we give a pt with DS?

Answer 18

Depends on the associated congenital anomalies–this may include cardia defects or strabismus

Question 19

Nursing care and ongoing care: we do what and teach parents what?

Answer 19

Manage secretions and prevention of URI—teach fam how to aspirate nasal secretions, rinse mouth after feedings, and use a cool mist in the room to assist moistening secretions

Question 20

Can we do postural drainage with percussion on a DS child?

Answer 20

Yes, we need to teach parents pulmonary hygiene by performing postural drainage with percussion

Question 21

What do we teach parents about the DS childs tongue?

Answer 21

Teach feeding strategies to accommodate for the protruding tongue

Question 22

What kind of diet should we give for DS child?

Answer 22

High fiber and fluid to prevent constopation

Monitor calorie intake to prevent obesity

Question 23

How do we monitor weight and height?

Answer 23

Plotting growth on DS growth chartt

Question 24

What should be evaluated frequently in DS child?

Answer 24

Eyesight and hearing—also provide frequent thyroid functioning tests

Question 25

What is atlantoaxial instability?

Answer 25

Something we assess for—it is neck pain, weakness, and torticollis

Question 26

What is a complication of DS?

Answer 26

Respiratory infections are COMMON due to decreased muscle tone and poor drainage of mucose because of HYPOTONICITY associated with underdeveloped nasal bone

Question 27

A nurse is teaching a group of parents about possible manifestation of DS. Which of the following should she include in the teaching? (SATA)

A. A large head with bulging fontanelles
B. Larger ears that are set back
C. Protruding abdomen
D. Broad, short feet and hands
E. Hypotonia

Answer 27

C, D, E