Nursing 209

N209: Reproductive Health Study Guide o Mixed: The most common is spastic-dyskinetic • Signs and symptoms in newborns: o Head lag when picked up o May feel stiff or floppy o Over-extension of back and neck when held o Stiff legs or scissoring when picked up • Diagnosis: Important to diagnose early o Screening and monitoring of development; usually during the first two years of life • Treatment: No standard treatment plan; based on specific needs o May include physical and occupational therapy, speech therapy, recreational therapy, assistance with eating, and drooling difficulties o Medications include:  Botulinum toxin: Via injection; relaxes muscle contractions by keeping the nerve cells from over-activating muscles  Intrathecal baclofen: Delivered via pump into intrathecal space; decreases the excitability of nerve cells in the spine, which can then decrease muscle spasticity in the body o Surgery: Muscle and tendon lengthening  Surgery to cut the overactive nerves at the base of the spine can be done when all other treatment fails (selective dorsal rhizotomy) • Other CP Complications: o Epilepsy o Incontinence o Osteopenia (poor bone density) o Pain o Arthritis o Depression Sickle Cell Disease (SCD) • A group of inherited red blood cell disorders, resulting in hard, sticky “sickle-shaped” red blood cells • The sickle cells die early, causing a shortage of RBCs ; they also get stuck traveling through small blood vessels causing occlusion • Sickle cell disease affects 90-100,000 people in the U.S. • SCD occurs in 1:500 African-American births • SCD occurs in 1:36,000 Hispanic-American births • With Sickle cell trait, one copy of the sickle cell gene mutation is inherited from one parent • Sickle cell trait (SCT) occurs in 1:12 African-Americans • Common Types of SCD: o HbSS: The most severe form; also referred to as sickle cell anemia; child inherits one sickle cell gene from each parent

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