Author Question: A 2-week-old infant with Down syndrome is being seen in the clinic. His mother tells the nurse that ... (Read 81 times)

anjilletteb · **on:** Jun 28, 2018

A 2-week-old infant with Down syndrome is being seen in the clinic. His mother tells the nurse that he is difficult to hold, that he's like a rag doll. He doesn't cuddle up to me like my other babies did.

What is the nurse's best interpretation of this lack of clinging or molding?
a. Sign of detachment and rejection
b. Indicative of maternal deprivation
c. A physical characteristic of Down syndrome
d. Suggestive of autism associated with Down syndrome

Question 2

The mother of a young child with cognitive impairment asks for suggestions about how to teach her child to use a spoon for eating. The nurse should make which recommendation?

a. Do a task analysis first.
b. Do not expect this task to be learned.
c. Continue to spoon feed the child until the child tries to do it alone.
d. Offer only finger foods so spoon feeding is unnecessary.

perkiness · **Reply #1 on:** Jun 28, 2018

Answer to Question 1

ANS: C
Infants with Down syndrome have hypotonicity of muscles and hyperextensibility of joints, which complicate positioning. The limp, flaccid extremities resemble the posture of a rag doll. Holding the infant is difficult and cumbersome, and parents may feel that they are inadequate. A lack of clinging or molding is characteristic of Down syndrome, not detachment. There is no evidence of maternal deprivation. Autism is not associated with Down syndrome, and it would not be evident at 2 weeks of age.

Answer to Question 2

ANS: A
Successful teaching begins with a task analysis. The endpoint (self-feeding, toilet training, and so on) is broken down into the component steps. The child is then guided to master the individual steps in sequence. Depending on the child's functional level, using a spoon for eating should be an achievable goal. The child requires demonstration and then guided training for each component of the self-feeding. Feeding finger foods so spoon feeding is unnecessary eliminates some of the intermediate steps that are necessary to using a fork and spoon. For socialization purposes, it is desirable that a child use feeding implements.