Chapter 34 Patients with Special Challenges

  1. Pervasive developmental disorder characterized by impairment of social interaction
    Autism
  2. Characterized by a genetic chromosomal defect that can occur during fetal development, resulting in mild to severe mental retardation
    Down syndrome
  3. Group of disorders characterized by poorly controlled body movement
    Cerebral palsy
  4. Unsteady gait
    ataxia
  5. Birth defect caused by incomplete closure of spinal column.  Spinal cord and undeveloped vertebrae are exposed.
    Spina bifida
  6. Most patients with spina bifida also have ____.  Requires the placement of a shunt to drain excessive amounts of cerebrospinal fluid from the brain.
    hydrocephalus
  7. Obese is __% to __% over the ideal weight.
    20% to 30%
  8. Severely obese is ___ to ___ lb over the ideal weight.
    50 to 100
  9. DOPE mnemonic helps to recognize cause of tracheotomy tube obstruction:
    • Displacement, dislodged, or damaged tube
    • Obstruction of the tube (secretions, blood, mucus, vomitus)
    • Pneumothorax, pulmonary problems
    • Equipment failure (kinked tubing, ventilator malfunction, empty oxygen supply)
  10. Special piece of medical equipment that takes over the function of either one or both heart ventricles.  Used as a bridge to heart transplantation while a donor heart is being located.
    Left ventricular assist devices
  11. Alternative treatment to medication for patients with chronic seizure disorders.  Surgically implanted in patients when medications fail to resolve seizure activity or if the patient is not a good candidate for brain surgery.
    Vagal nerve stimulators
  12. All of the following are associated with Down syndrome EXCEPT:



    D. narrow-set eyes.
  13. Which of the following is NOT a potential complication for Down syndrome patients?



    C. respiratory
  14. All of the following are possible causes of cerebral palsy EXCEPT:



    B. preeclampsia
  15. Cerebral palsy is associated with all of the following conditions EXCEPT:



    D. cardiovascular complications
  16. Central venous catheters are located in all of the following areas EXCEPT:



    D. the lower leg
  17. When approaching a developmentally disabled patient, the best plan of action is to:
    A. approach the patient as you would any other patient.
    B. speak directly with family members.
    C. approach with a partner in case the patient becomes violent.
    D. wait for law enforcement before you approach the patient.
    A. approach the patient as you would any other patient.
  18. You are assessing a 440-lb man who complains of shortness of breath and lower back pain. The patient is conscious and alert, his blood pressure is 148/98 mm Hg, and his heart rate is 120 beats/min. Your MOST immediate action should be to:
    A. notify the receiving facility and advise them of the patient's weight and status.
    B. ask a member of your team to locate the best route to move him to the ambulance.
    C. perform a secondary assessment, focusing on his respiratory system and back.
    D. avoid placing him in a supine position if possible and administer oxygen.
    D. avoid placing him in a supine position if possible and administer oxygen.
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Chapter 34 Patients with Special Challenges
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Chapter 34 Patients with Special Challenges
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