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MENTAL RETARDATION

Mental Retardation
Etiology
Genetic conditions:
Ex: Down syndrome (trisomy 21), fragile X syndrome, and
phenylketonuria (PKU).

Prenatal problems:
Ex: a woman who drinks alcohol ,  infections during pregnancy
such as rubella, syphilis, HIV.

Perinatal problems:
Ex: dystocia, birth trauma, severe prematurity, diseases of
mother during pregnancy such as heart and kidney disease,
GDM.
Health Disorders:
Ex: Tuberculosis, Meningitis, Cretinism, Whooping cough,
Measles
Four Different Degrees Of
Mental Retardation
(based on Person’s Level of Function)

I.Mild Mental Retardation


> IQ score ranges from 50–70
> can often acquire academic skills up to the 6th grade level
> fairly self-sufficient and in some cases live independently,
with community and social support

II. Moderate Mental Retardation


> IQ scores ranging from 35-55
> carry out work and self-care tasks with moderate
supervision
>  typically acquire communication skills in childhood and are
able to live and function successfully within the community in
a supervised environment such as a group home

III. Severe Mental Retardation


> IQ scores of 20-40
> they may master very basic self-care skills and some
communication skills
> many severely retarded individuals are able to live in a
group home
IV. Profound Mental Retardation
> IQ scores under 20-25
> they may be able to develop basic self-care and
communication skills with appropriate support and training
> often caused by accompanying neurologic disorder
> need a high level of structure and supervision
Categories describe the level of support required by

AAMR or American Association on


Mental Retardation

I.Intermittent Support

II.Limited Support

III.Extensive Support

IV.Pervasive Support
Signs and Symptoms
> Continued infant-like behavior
> Decreased learning ability
> Failure to meet the markers of intellectual development
> Inability to meet educational demands at school
> Lack of curiosity
> Delayed development of skills
> Speech and language poor coordination of movements
> Emotional immaturity
Nursing Management
1.Assess all children for signs of developmental delays.

2. Administer prescribed medications for associated problems


such as anticonvulsants for seizure disorders, and
methylphenidate (Ritalin) for attention deficit hyperactivity
disorder.

3. Support the family at the time of initial diagnosis by actively


listening to their feelings and concerns and assessing
their composite strengths.
4. Facilitate the child’s self-care abilities by encouraging the
parents to enroll the child in an early stimulation program,
establishing a self-feeding program, initiating independent
toileting, and establishing an independent grooming program (all
developmentally appropriate).

5. Promote optimal development by encouraging self-care goals


and emphasize the universalneeds of children, such as play,
social interaction and parental limit setting.

6. Promote anticipatory guidance and problem solving by


encouraging discussions regarding physical maturation and
sexual behaviors.
7. Assist the family in planning for the child’s future needs (e.g.
Alternative to home care, especially as the parents near old age);
refer them to community agencies.

8. Provide child and family teaching

9. Encourage the prevention of mental retardation


> Encourage early and regular prenatal care.
> Provide support for high risk infants.
> Administer immunizations, especially rubella immunization.
> Encourage genetic counseling when needed.
> Teach injury prevention – both intentional and unintentional.
Prioritized Nursing Diagnosis
Ineffective Health Maintenance r/t presence of mental illness

Impaired social interaction r/t absence of available significant


others or peers

Ineffective coping r/t decreased learning ability

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