SlideShare una empresa de Scribd logo
1 de 44
Descargar para leer sin conexión
Down Syndrome Johana Seminiano, RN, BSN Regis College Spring 2011 NU665B
Down Syndrome: Prevalence & Incidence ,[object Object],[object Object],[object Object]
Down Syndrome: Mortality & Morbidity ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Down Syndrome: Prognosis ,[object Object],[object Object],[object Object]
ACOG: Recommendations for Down Syndrome Screening ,[object Object],[object Object],[object Object],[object Object],[object Object]
Anticipatory Guidance: Patients Considering Screening ,[object Object],[object Object],[object Object],[object Object],[object Object]
Anticipatory Guidance: Management of Screening Results ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Anticipatory Guidance: Diagnostic Test ,[object Object],[object Object],[object Object],[object Object]
Management of Pregnancy ,[object Object],[object Object],[object Object],[object Object]
 
 
 
 
 
 
Age Evaluate Anticipatory Guidance Newborn Feeding, Vision (strabismus, cataracts, nystagmus), congenital hearing loss, respiratrory heart defects, constipation
Developmental Characteristics: Intellectual Disability ,[object Object],[object Object],[object Object]
 
Health Promotion: Intellectual Disability ,[object Object],[object Object],[object Object]
Health Promotion: Intellectual Disability ,[object Object]
Presentation: Growth ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
Health Promotion: Obesity prevention ,[object Object],[object Object]
 
Presentation: Heart Disease ,[object Object],[object Object],[object Object],[object Object],[object Object]
Presentation: GI Abnormalities ,[object Object],[object Object],[object Object],[object Object],[object Object]
Presentation: Eye Problems ,[object Object],[object Object],[object Object],[object Object],[object Object]
Health Promotion: Eye Problems ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Presentation: Hearing Loss ,[object Object],[object Object],[object Object]
Health Promotion: Hearing ,[object Object],[object Object],[object Object],[object Object]
Presentation: Hematologic Disorders ,[object Object],[object Object],[object Object],[object Object]
Health Promotion: Hematologic Disorders ,[object Object],[object Object],[object Object],[object Object]
Presentation: Thyroid Disease ,[object Object],[object Object],[object Object],[object Object],[object Object]
Health Promotion: Thyroid function ,[object Object],[object Object],[object Object]
Presentation: Periodontal Disease ,[object Object],[object Object],[object Object]
Presentation: Atlantoaxial Instabilitiy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Atlantoaxial Instability
Presentation: Sleep Apnea ,[object Object],[object Object],[object Object]
 
References ,[object Object],[object Object],[object Object]
References ,[object Object],[object Object],[object Object]
References ,[object Object],[object Object],[object Object],[object Object],[object Object]
References ,[object Object],[object Object],[object Object],[object Object]

Más contenido relacionado

La actualidad más candente

Approach to developmental delay
Approach to developmental delay Approach to developmental delay
Approach to developmental delay Bashar Mudallal
 
Chronic Kidney Disease in Pediatrics
Chronic Kidney Disease in PediatricsChronic Kidney Disease in Pediatrics
Chronic Kidney Disease in PediatricsDrhunny88
 
Down syndrome ppt for UGs
Down syndrome ppt for UGsDown syndrome ppt for UGs
Down syndrome ppt for UGsgiridharkv
 
Attention deficit hyperactivity disorder (adhd)
Attention deficit hyperactivity disorder (adhd)Attention deficit hyperactivity disorder (adhd)
Attention deficit hyperactivity disorder (adhd)Nishant Agarwal
 
Down syndrome Class Presentation
Down syndrome Class PresentationDown syndrome Class Presentation
Down syndrome Class Presentationsallypsychology
 
Global developmental delay & Intellectual disability
Global developmental delay & Intellectual disabilityGlobal developmental delay & Intellectual disability
Global developmental delay & Intellectual disabilityDrDilip86
 
Down syndrome by Dr. Rubzzz
Down syndrome by Dr. RubzzzDown syndrome by Dr. Rubzzz
Down syndrome by Dr. RubzzzDr. Rubz
 
Bronchial asthma in children
Bronchial asthma in children Bronchial asthma in children
Bronchial asthma in children Azad Haleem
 
An approach to a Floppy infant - Dr Sujit
An approach to a Floppy infant - Dr SujitAn approach to a Floppy infant - Dr Sujit
An approach to a Floppy infant - Dr SujitSujit Shrestha
 
bronchiolitis in paediatrics
bronchiolitis in paediatricsbronchiolitis in paediatrics
bronchiolitis in paediatricsmeducationdotnet
 
Pediatric malabsorption syndromes
Pediatric  malabsorption syndromesPediatric  malabsorption syndromes
Pediatric malabsorption syndromesAzad Haleem
 
Cereberal palsy dr hussein abass 2019 ppt
Cereberal palsy dr hussein abass  2019  pptCereberal palsy dr hussein abass  2019  ppt
Cereberal palsy dr hussein abass 2019 pptHosin Abass
 

La actualidad más candente (20)

Approach to developmental delay
Approach to developmental delay Approach to developmental delay
Approach to developmental delay
 
Chronic Kidney Disease in Pediatrics
Chronic Kidney Disease in PediatricsChronic Kidney Disease in Pediatrics
Chronic Kidney Disease in Pediatrics
 
childhood asthma
childhood asthmachildhood asthma
childhood asthma
 
Lecture - Down Syndrome
Lecture - Down SyndromeLecture - Down Syndrome
Lecture - Down Syndrome
 
Down syndrom
Down syndromDown syndrom
Down syndrom
 
Down syndrome ppt for UGs
Down syndrome ppt for UGsDown syndrome ppt for UGs
Down syndrome ppt for UGs
 
Attention deficit hyperactivity disorder (adhd)
Attention deficit hyperactivity disorder (adhd)Attention deficit hyperactivity disorder (adhd)
Attention deficit hyperactivity disorder (adhd)
 
Turner syndrome
Turner syndromeTurner syndrome
Turner syndrome
 
Down syndrome Class Presentation
Down syndrome Class PresentationDown syndrome Class Presentation
Down syndrome Class Presentation
 
Global developmental delay & Intellectual disability
Global developmental delay & Intellectual disabilityGlobal developmental delay & Intellectual disability
Global developmental delay & Intellectual disability
 
Down syndrome by Dr. Rubzzz
Down syndrome by Dr. RubzzzDown syndrome by Dr. Rubzzz
Down syndrome by Dr. Rubzzz
 
PAEDIATRICS HIV
PAEDIATRICS HIVPAEDIATRICS HIV
PAEDIATRICS HIV
 
Bronchial asthma in children
Bronchial asthma in children Bronchial asthma in children
Bronchial asthma in children
 
Failure To Thrive
Failure To ThriveFailure To Thrive
Failure To Thrive
 
An approach to a Floppy infant - Dr Sujit
An approach to a Floppy infant - Dr SujitAn approach to a Floppy infant - Dr Sujit
An approach to a Floppy infant - Dr Sujit
 
bronchiolitis in paediatrics
bronchiolitis in paediatricsbronchiolitis in paediatrics
bronchiolitis in paediatrics
 
Pediatric malabsorption syndromes
Pediatric  malabsorption syndromesPediatric  malabsorption syndromes
Pediatric malabsorption syndromes
 
DOWNS SYNDROME (PPT)
 DOWNS SYNDROME  (PPT) DOWNS SYNDROME  (PPT)
DOWNS SYNDROME (PPT)
 
Cereberal palsy dr hussein abass 2019 ppt
Cereberal palsy dr hussein abass  2019  pptCereberal palsy dr hussein abass  2019  ppt
Cereberal palsy dr hussein abass 2019 ppt
 
Downs syndrome
Downs syndromeDowns syndrome
Downs syndrome
 

Destacado

Down syndrome presentation
Down syndrome   presentationDown syndrome   presentation
Down syndrome presentationEuridiki
 
Down syndrome Characteristics, Diagnosis, Prognosis, Treatment
Down syndrome Characteristics, Diagnosis, Prognosis, TreatmentDown syndrome Characteristics, Diagnosis, Prognosis, Treatment
Down syndrome Characteristics, Diagnosis, Prognosis, TreatmentYuti Doshi
 
Down syndrome
Down syndromeDown syndrome
Down syndromeNatalie
 
Down syndrome presentation
Down syndrome presentationDown syndrome presentation
Down syndrome presentationwannarite2
 
Down Syndrome Presentation
Down Syndrome PresentationDown Syndrome Presentation
Down Syndrome PresentationElpidia Medina
 
Down Syndrome.ppt
Down Syndrome.pptDown Syndrome.ppt
Down Syndrome.pptShama
 
Down syndrome awareness
Down syndrome awareness Down syndrome awareness
Down syndrome awareness SARA ISMAIL
 
Down Syndrome Cognition Research 101: An Introduction
Down Syndrome Cognition Research 101: An IntroductionDown Syndrome Cognition Research 101: An Introduction
Down Syndrome Cognition Research 101: An Introductionplus15campaign
 
Down syndrome
Down syndromeDown syndrome
Down syndromeasteinman
 
Down Syndrome: Born with Extra
Down Syndrome: Born with ExtraDown Syndrome: Born with Extra
Down Syndrome: Born with Extrasamnham
 
 Genetic deseases. Down syndrome
 Genetic deseases. Down syndrome Genetic deseases. Down syndrome
 Genetic deseases. Down syndromeFeko91
 

Destacado (20)

Down Syndrome
Down  SyndromeDown  Syndrome
Down Syndrome
 
Down syndrome presentation
Down syndrome   presentationDown syndrome   presentation
Down syndrome presentation
 
Down Syndrome
Down SyndromeDown Syndrome
Down Syndrome
 
Down Syndrome
Down SyndromeDown Syndrome
Down Syndrome
 
Down syndrome Characteristics, Diagnosis, Prognosis, Treatment
Down syndrome Characteristics, Diagnosis, Prognosis, TreatmentDown syndrome Characteristics, Diagnosis, Prognosis, Treatment
Down syndrome Characteristics, Diagnosis, Prognosis, Treatment
 
Down syndrome
Down syndromeDown syndrome
Down syndrome
 
What Is Down Syndrome?
What Is Down Syndrome?What Is Down Syndrome?
What Is Down Syndrome?
 
Down syndrome presentation
Down syndrome presentationDown syndrome presentation
Down syndrome presentation
 
Down Syndrome Presentation
Down Syndrome PresentationDown Syndrome Presentation
Down Syndrome Presentation
 
Down Syndrome
Down SyndromeDown Syndrome
Down Syndrome
 
Down Syndrome.ppt
Down Syndrome.pptDown Syndrome.ppt
Down Syndrome.ppt
 
Down syndrome
Down syndromeDown syndrome
Down syndrome
 
Down Syndrome
Down SyndromeDown Syndrome
Down Syndrome
 
Down syndrome awareness
Down syndrome awareness Down syndrome awareness
Down syndrome awareness
 
Down Syndrome Cognition Research 101: An Introduction
Down Syndrome Cognition Research 101: An IntroductionDown Syndrome Cognition Research 101: An Introduction
Down Syndrome Cognition Research 101: An Introduction
 
Down syndrome
Down syndromeDown syndrome
Down syndrome
 
Down Syndrome: Born with Extra
Down Syndrome: Born with ExtraDown Syndrome: Born with Extra
Down Syndrome: Born with Extra
 
Down syndrome
Down syndromeDown syndrome
Down syndrome
 
Down syndrome
Down syndromeDown syndrome
Down syndrome
 
 Genetic deseases. Down syndrome
 Genetic deseases. Down syndrome Genetic deseases. Down syndrome
 Genetic deseases. Down syndrome
 

Similar a Care of Pediatric Down Syndrome

Similar a Care of Pediatric Down Syndrome (20)

داون
داون داون
داون
 
A review study on down syndrome disease
A review study on down syndrome disease A review study on down syndrome disease
A review study on down syndrome disease
 
Down syndrome
Down syndromeDown syndrome
Down syndrome
 
Down’s syndrome health problems and strategies for care
Down’s syndrome health problems  and strategies for careDown’s syndrome health problems  and strategies for care
Down’s syndrome health problems and strategies for care
 
Peculiarities of children in differnet age group
Peculiarities of children in differnet age groupPeculiarities of children in differnet age group
Peculiarities of children in differnet age group
 
Down syndrome
Down syndromeDown syndrome
Down syndrome
 
Down syndrom
Down syndromDown syndrom
Down syndrom
 
Down syndrome - Child Health Nursing, M.Sc(N)
Down syndrome - Child Health Nursing, M.Sc(N)Down syndrome - Child Health Nursing, M.Sc(N)
Down syndrome - Child Health Nursing, M.Sc(N)
 
Growth Disorders
Growth DisordersGrowth Disorders
Growth Disorders
 
Diseases.pptx
Diseases.pptxDiseases.pptx
Diseases.pptx
 
Down syndrome
Down syndromeDown syndrome
Down syndrome
 
Down syndrome - A Parent's perspective
Down syndrome - A Parent's perspectiveDown syndrome - A Parent's perspective
Down syndrome - A Parent's perspective
 
Down Syndrome
Down SyndromeDown Syndrome
Down Syndrome
 
Genetic counseling
Genetic counselingGenetic counseling
Genetic counseling
 
Causes & prevention of disabilities
Causes & prevention of disabilitiesCauses & prevention of disabilities
Causes & prevention of disabilities
 
PHYSIOTHERAPY MANAGEMENT IN DOWN SYNDROM
PHYSIOTHERAPY MANAGEMENT IN DOWN SYNDROMPHYSIOTHERAPY MANAGEMENT IN DOWN SYNDROM
PHYSIOTHERAPY MANAGEMENT IN DOWN SYNDROM
 
Down Syndrome
Down SyndromeDown Syndrome
Down Syndrome
 
Turner's syndrome
Turner's syndromeTurner's syndrome
Turner's syndrome
 
Sirenomeli Mermaid Syndrome
Sirenomeli Mermaid SyndromeSirenomeli Mermaid Syndrome
Sirenomeli Mermaid Syndrome
 
Trisomy21
Trisomy21Trisomy21
Trisomy21
 

Care of Pediatric Down Syndrome

Notas del editor

  1. Heinzman, D. and Khan, S (July 2010). Down Syndrome. Accessed via MDConsult on February 4, 2011 at http://phstwlp1.partners.org:2872/das/pdxmd/body/235051741-11/1114849877?type=med&eid=9-u1.0-_1_mt_1014362#Contributors
  2. Chen H. (Feb 20110). Down Syndrome. Accessed via eMedicine on February 6, 2011 from http://emedicine.medscape.com/article/943216-overview
  3. Chen H. (Feb 20110). Down Syndrome. Accessed via eMedicine on February 6, 2011 from http://emedicine.medscape.com/article/943216-overview
  4. American Congress of Obstetrics & Gynecology (2007). New Recommendations for Down Syndrome: Screening Should Be Offered to All Pregnant Women. Accessed on February 4, 2011 from http://www.acog.org/from_home/publications/press_releases/nr01-02-07-1.cfm
  5. Families weigh this decision individually Barss, V.A., Messerlian, G.M., & Canick, J.A. (2009). Overview of prenatal screening and diagnosis of Down syndrome. Accessed via UptoDate on January 31, 2011 from http://www.uptodate.com/online/content/topic.do?topicKey=antenatl/16784&source=see_link&anchor=H4#H4
  6. The actual risk for the patient is provided in the report (eg, Down syndrome risk 1 in 900) and this number should be given to the patient. Barss, V.A., Messerlian, G.M., & Canick, J.A. (2009). Overview of prenatal screening and diagnosis of Down syndrome. Accessed via UptoDate on January 31, 2011 from http://www.uptodate.com/online/content/topic.do?topicKey=antenatl/16784&source=see_link&anchor=H4#H4
  7. Barss, V.A., Messerlian, G.M., & Canick, J.A. (2009). Overview of prenatal screening and diagnosis of Down syndrome. Accessed via UptoDate on January 31, 2011 from http://www.uptodate.com/online/content/topic.do?topicKey=antenatl/16784&source=see_link&anchor=H4#H4
  8. NST, BPP, antepartum tests: It is reasonable to use these tests for the usual obstetrical indications (eg, fetal growth restriction, oligohydramnios, preeclampsia, decreased fetal movement).
  9. The baby is born, the NP needs to provide anticipatory guidance and emotional support. Goal at this time is to encourage a healthy bond. This is an emotional time for families whether it was prenatally diagnosed or not. There are terms to recognize in the physical presentation of DS but certainly these are more academic purposes, I don’t think parents want to hear upslanting palpebral fissures. They may have health promotion inquiries regarding their baby’s vision health instead. Physical Characteristics: Dysmorphic Features Brachycephaly Upslanting palpebral fissures Epicanthic folds Brushfield spots – small white/graying brown spots on periphery of the iris Flat nasal bridge Folded or dysplastic ears Small ears Open mouth Protruding tongue Furrowed tongue Narrow palate Abnormal teeth Short neck Excessive skin at nape of the neck
  10. Protruded tongue, epicanthal folds, slanted palpebral fissures
  11. Physical Characteristics: Dysmorphic Features Affecting the Extremities Short broad hands Hypoplastic mid phalanx of fifth finger Incurved fifth finger Transverse palmar crease Space between the first and second toes (sandal gap deformity) Hyperflexibility of joints
  12. A picture to depict common areas of concern which we’ll go over.
  13. Roizen, N.J. and Stark, A.R. (Oct. 2009). Management of Down syndrome. Accessed via UpToDate on January 31, 2011 from http://www.uptodate.com/online/content/topic.do?topicKey=dis_chld/7271&source=related_link
  14. The profile of cognitive impairment in DS appears to differ from other forms of intellectual disability. Impairment in expressive language was noted in another study of children with DS, who had fewer different and total words and decreased mean length of utterance compared to controls matched for nonverbal mental age. Vocabulary skills accelerated more rapidly than syntax (average sentence length and structure) and surpassed mental age in adolescence. Similar findings of increasing differences in comprehension with age were noted in another report, in which children with DS developed relatively stronger skills in vocabulary compared to syntax. Other selective deficits have been described, such as greater difficulty understanding sequences or grammatical rules. Barss, V.A., Messerlian, G.M., & Canick, J.A. (2009). Overview of prenatal screening and diagnosis of Down syndrome. Accessed via UptoDate on January 31, 2011 from http://www.uptodate.com/online/content/topic.do?topicKey=antenatl/16784&source=see_link&anchor=H4#H4
  15. The cause of DS-associated growth retardation remains unknown; low circulating levels of IGF-1 and diminished provoked and spontaneous secretion of GH have been reported in some patients [ 36,37 ]. Serum GH levels are not low in children with DS [ 38,39 ], but suboptimal endogenous GH production as a result of hypothalamic dysfunction has been demonstrated [ 40 ]. Selective deficiency of IGF-1, but not IGF-II, has been seen in Down syndrome patients who are older than two years [ 41,42 ]. IGF-1 receptors are present in brain cells from fetuses with trisomy 21 [ 42 ]. This is thought to result from the reduced resting metabolic rate in children and adults with DS [ 43,44 ]. In general, weight is less than expected for length in infants with DS, and then increases disproportionally so [ 8 ]. Barss, V.A., Messerlian, G.M., & Canick, J.A. (2009). Overview of prenatal screening and diagnosis of Down syndrome. Accessed via UptoDate on January 31, 2011 from http://www.uptodate.com/online/content/topic.do?topicKey=antenatl/16784&source=see_link&anchor=H4#H4
  16. This and the following information will help the NP provide good anticipatory guidance. Educate the parents that the growth and development growth charts available is standardized to capture average children without Down Syndrome, their baby will have their own growth chart Barss, V.A., Messerlian, G.M., & Canick, J.A. (2009). Overview of prenatal screening and diagnosis of Down syndrome. Accessed via UptoDate on January 31, 2011 from http://www.uptodate.com/online/content/topic.do?topicKey=antenatl/16784&source=see_link&anchor=H4#H4
  17. American Academy of Pediatrics http://aappolicy.aappublications.org/cgi/content/full/pediatrics;107/2/442
  18. Barss, V.A., Messerlian, G.M., & Canick, J.A. (2009). Overview of prenatal screening and diagnosis of Down syndrome. Accessed via UptoDate on January 31, 2011 from http://www.uptodate.com/online/content/topic.do?topicKey=antenatl/16784&source=see_link&anchor=H4#H4
  19. Murray, J., Ryan-Krause, P. (2010). Obesity in Children with Down Syndrome: Background and Recommendations for Management Pediatric Nursing, 36(6):314-319. Accessed via Medscape on Feb. 2, 2011 from http://www.medscape.com/viewarticle/734672_4
  20. The characteristics of hearing loss were illustrated by a study of 47 children with DS, two months to 3.5 years of age, evaluated by auditory brainstem response testing. Monitoring for this condition is important to preserve hearing.
  21. In a Dutch study in children up to 14 years of age, the risk of type I diabetes is 3x greater in DS than in the general population
  22. Height & weight are to be obtained since since the combination of slow of linear growth associated with weight gain is a sensitive indicator of hypothyroidism
  23. The mechanism is thought to be because of alterations in mouth flora, with a higher frequency of Actinobacillus actinomycetemcomitans compared to controls Anticipate that the cooperation necessary for many orthodontic procedures may make them impractical in this population.
  24. Van Cleve, S.N., and Cohen, W.I. (2006). Part I: Clinical Practice Guidelines With Down Syndrome From Birth to 12 Years. Journal of Pediatric Health Care, 20 (1):47-54 . Retrieved on January 31, 2011 from http://www.medscape.com/viewarticle/521906