CENTRO ESCOLAR UNIVERSITY MAKATI COLLEGE OF NURSING

CASE ANALYSIS DOWN SYNDROME May 9-11, 2012 Elsie Gaches Village

Submitted by: Dela Cruz, Christal Carmel F. BSN3A-A1

Submitted to: Ms. Emerald Alcala, RN Clinical Instructor

I.

OBJECTIVES

To be able to demonstrate the skills necessary to provide for the efficient and safe management of mentally retarded patients

To be able to demonstrate an ability to interact with patients, other health care providers in a professional, compassionate and efficient manner.

To be able to apply knowledge, skills and attitude in a setting which will help them learn how to deal with clients with cognitive ailment.

II.

INTRODUCTION Trisomy 21 or Down Syndrome is a chromosomal disease.

III.

PERSONAL DATA The Client is a female in her late 20s. Not much is known about her background

because her files and most of the clients in the cottage are kept confidential.

IV.

DEVELOPMENTAL THEORIES

AGE/STAGE Psychosocial Theory by Erik Erickson Identity vs. Role Confusion Interpersonal Theory by Harry Stack Sullivan Late Adolescence Cognitive Theory by Jean Piaget Formal Operational Psychosexual Theory by Sigmund Freud Genital Stage

DEVELOPMENTAL TASK

APPLICATION

V.

DESCRIPTION OF ADAPTIVE FUNCTION

a. Communication The Client does talk but it is hard to understand what she is saying. She sometimes speaks in monosyllables but most of the time; her sentences

only contain two to three words. She smiles often and understands what is being said to her. b. Self-Care The Client can bathe and change her clothes herself. She also takes care of her fellow patients in that aspect. After eating, the Client washes her mouth and face. c. Social Interaction When the Client is approached by people and says hello, she responds back and usually smiles at them. But if she is not talked to, she usually just keeps to herself. When walking with the student nurse, she does not hold the student nurses hand nor was she clingy upon interaction unlike the others. d. Self-Direction The Client is aware of where she is going, where the things are properly stored and also where her cottage is. e. Functional Academic Skills When the Art Therapy was conducted, the Client drew the house parent and seems to write letters, though it is not the alphabet. She cannot write her own name.

f. Work The Client is one of the trainable patients in the cottage and as mentioned above, she dresses other patients. She also cleans up after herself after eating.

g. Leisure The Client likes to stay by the window of the cottage and sit there. When she is in the playground, her favorite place is where the swings are. h. Health

As observed, there are no skin impairment present in the Client though she has a cough at the time of duty. i. Safety The Client can roam around the area but upon observation, she is concerned for her safety.

VI.

OBSERVED CHARACTERISTICS CHARACTERISTICS OF MENTAL RETARDATION Affect Isolation Unrelatedness to others Twiddling behavior Inconsistent developmental continuity Self-destructive behavior Temper tantrums/Anxiety I/you apparent confusion Concrete Thinking Perceptual Inconsistencies Immediate & Delayed echolalia Orderliness / / / / / / / / / / / OBSERVED NOT OBSERVED

Physical Incoordination Language Excessive Activity /

VII.

PHYSICAL DESCRIPTION The Client is in her late 20s. She is about 4 feet 5 inches tall. Her hair is cut

short. Her body build is of medium size. Her skin is fair. The Clients left ring finger us cut off. Simian lines are present in both hands and her toes are not proportionate. Both her fourth toes are relatively smaller than the other toes.

VIII.

NURSE-PATIENT INTERACTION (NPI)

NURSE-PATIENT INTERACTION (VERBATIM)

RATIONALE OF THE NURSES COMMUNICATION TECHNIQUES

ANALYSIS OF THE PATIENTS RESPONSE

Nurse:

Hello!

Anong Asking question open-ended to and achieve depth in

The Client smiles.

pangalan mo? Ako pala si -using Christal and student nurse questions mo. Client: Ako si Jenny. relevance discussion

Giving Information -making available facts that the client needs. Nurse: Ilang taon ka na? The Client smiles again.

Client: Thirteen

Asking question -using questions relevance discussion to and open-ended achieve depth in

Nurse: So Jenny, kamusta Asking question ka naman? Ano ang -using mo questions relevance discussion to and open-ended achieve depth in The Client just smiles at the nurse and does not answer.

nararamdaman ngayon?

Client: Does not answer.

Nurse: Gusto mo bang Asking question pumunta sa playground? Client: Sige! -using questions relevance discussion to and

The Client walks beside the

open-ended Client to the playground. achieve depth in

IX.

REVIEW OF RELATED LITERATURE AND STUDIES

Reaction to the topic

X.

LEARNING INSIGHTS Having my mind set on having my duty in Waling-Waling, I did not expect to be

assigned in the cottage Camia. It was a totally different place that what I expected, more so to the previous cottage that I was assigned, which was Juan Bonal where the profound females are housed. When my group arrived, I immediately noticed that the patients are the ones who clean the cottage. They were mopping and sweeping the floors. After eating, it was a custom to us that we were the ones who will clean after them, but the house parent approached us and told us that we should let the trainable patients do it because they are training them. So honestly speaking, it wasnt hard being there. All we have to do was to facilitate therapies and take our assigned clients out for a stroll. I learned that these clients are easily attached to us and that we should not be over familiar with them. It is for their well-being and to avoid them getting hurt. I also learned that not all cottages are the same and I believe that every time you have a duty in EGV, it will be a different experience.