Care for Pediatric patient with Sensory or Cognitive Impairment
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| How many infants are born with permanent hearing loss? | Up to 2:1000
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| What is conductive hearing loss? | Interference of transmission of sound to the middle ear
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| What is Perceptive or Nerve Deafness? | Damage to the inner ear structures or the auditory nerve
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| What is Central Auditory Imperception? | all hearing losses that does not demonstrate defects in the conductive or sensorineural structures
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| What si functional hearing loss? | Hearing loss occurs without lesions or other explanations for central hearing loss
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| What defects cause hearing loss? | Defect in sound transmission, damage to nerve pathways or a mixture of both
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| What is otitis media? | Inflammation and fluid in the middle ear
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| What may be the causes of otitis media? | RSV and H. influenzae, passive smoking increases risks.
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| What ages are otitis media common in, and in what gender is it more common? | Ages 0-7, more commmon in boys
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| What are the most common bacterias involved in otitis media? | *Streptococcus pneumoniae *H. Influenzae and Moraxella
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| In a child with otitis media, how will the tympanic membrane appear? | bulging and red
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| S/Sx of otitis media: | *Ear pain *Fever *Purulent discharge *Irritability and restlessness *Holding, rubbing, or pulling on affected ear
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| What can result from chronic otitis media? | *Hearing loss *Tinnitus *Vertigo
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| What is the Tx of otitis media? | *Spontaneous resolution *Antibiotics (Amoxicillin, Ceftriaxone) *Myringotomy *PE tubes if there are recurrent episodes of long duration.
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| True or False: The method the child is fed can cause otitis media | True. Feed sitting up to prevent OM
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| To inspect the ear canal in an older child, what is the proper method of pulling the pinna? | Up and back
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| What is the visual acuity of a newborn? | Around 20/400
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| When does a childs visual acuity reach 20/30 to 20/20? | 2 - 3 years of age
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| For what age of children is the snellen letter chart most effective? | 6 years or older
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| What visual acuity testing chart is useful for children who dont know the alphabet having the child point in the direction the letter is facing? | Tumbling E
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| What visual acuity testing chart uses common figures/shapes to test vision? | Allen card
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| How is visual acuity tested in newborns? | by checking light perception
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| What is indicative of vision in newborns? | The ability to fix on and follow a target is an indication of vision
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| What visual problems can be corrected by corrective lenses? | *Myopia *Hyperopia *Amblyopia
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| What is myopia? | Near-sightedness, the light rays are bent and falls short of the retina (focuses before retina)
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| What is hyperopia? | Far-sightedness, the light rays are bent and focuses past the retina
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| What is emmetropia? | "normal" bend of light so the light focus right on the retina
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| What is Strabismus? | Eye muscles do not coordinate (cross eye). Can affect either one or both eyes and results in two images instead of one being received by the brain
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| What are common S/Sx of strabismus? | *Squinting *Closing one eye *Tilting head *Difficulty focusing
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| What is Amblyopia? | “lazy eye” unclear image in effected eye – causing double vision
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| True or False: The goal of medical interventions of one with strabismus is to return the eyes to normal functioning and position | False. There is no treatment that will perfectly align the eyes. The goal therefore is to realign them as close to normal as possible.
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| What is legal blindness? | Visual acuity of 20/200 or less and a visual field of 20 degrees or less
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| What are the most common types of visual disorders in children? | Refractive errors
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| What is a Retinoblastoma? | a rare, cancerous tumor of the retina. One or both eyes may be affected
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| S/Sx of retinoblastoma: | *Cat’s eye reflex *Strabismus *Red, painful eye *Pupil may appear white or have white spots *A glow in affected eye is often seen in photographs
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| What is enucleation? | Surgical removal of the eye
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| How many children does autism occur in, and in which gender is it more likely to develope? | 1 in 500, males
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| What is the hallmark symptom of autism? | Failure to make eye contact
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| What are the three components in diagnosing cognitive impairment? | *Intellectual functioning with an IQ of 70 or less *Impairment in at least 2 of 10 different skills *Younger than 18 years old when diagnosed
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| What are the classifications of cognitive impairment? | *Educable mentally retarded (mild) *Trainable mentally retarded (moderate)
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| When is a Dx of cognitive impairment made? | After developmental progress is delayed
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| What are the causes of cognitive impairment? | *Genetic *Biochemical *Infectious *Other unknown causes
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| What is the most common chromosomal abnormality and how many births does it occur in? | Down Syndrome, 1:800 - 1:1000 births
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| 95% of children with down syndrome have what? | An extra chromosome 21
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| What physical problems are associated with down syndrome? | *Congenital heart malformations *Respiratory infections *Thyroid dysfunction
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| What can be done to lessen the chances of respiratory infection in children with down syndrome? | *Using bulb syringe *Rinse mouth after feedings *Increasing fluid intake *Use a cool-mist vaporizer
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| How does Fragile X Syndrome appear in adult men? | *Long faces with prominent jaw *Large protruding ears *Large testes
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| What medication is used to control outbursts in children with Fragile X Syndrome? | Seratonin agents
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| What medications are used to improve attention span in children with Fragile X Syndrome? | CNS stimulants such as clonidine
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