Health Care Guidelines

The National Down Syndrome Society (NDSS) publishes a set of Health Care Guidelines for Individuals with Down Syndrome, which reflect current standards and practices in the United States. NDSS emphasizes that people with Down syndrome need the usual health care screening procedures, immunizations, and preventive health measures that are used for the population at large.

NDSS also recognizes that individuals with Down syndrome have some unique risks as well as different levels of risks for particular diseases and disorders. The health guidelines provide a framework to detect disorders within these risk categories.


INSTANT FEEDBACK:
There are specific health care guidelines for adults with Down syndrome, which should be used in conjunction with the usual health care screening procedures and preventive health measures.
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False


The NDSS Health Care Guidelines address the following categories for adults with Down syndrome:

History: In addition to the usual medical history questions used for typically-developing adults, the clinician should gather data about:

Nurses can help the client prepare a list of questions and concerns to discuss during the history-taking. If the client’s cognitive function is significantly impaired, the nurse may want to send the health care provider written information about the client or attend the appointment in person.


Exam: In addition to a general physical and neurological exam, the clinician should follow these recommendations:

Because many components of the physical examination can be bothersome or even traumatic for an adult with Down syndrome, nurses can help prepare the client by describing the procedure in a manner consistent with the individual’s cognitive status. In some cases, the nurse’s presence during the exam can be quite comforting.


INSTANT FEEDBACK:
Because sexual activity is so unlikely in women with Down syndrome, Pap smears are not considered a standard part of preventive health care for this population.
True
False

Labs and consults:

While some primary health care providers will automatically schedule labs and consults for adults with Down syndrome, others do not manage this type of care. Nurses working with the adult may arrange these appointments directly, contact the adult with periodic reminders, or simply set up a tickler system. Nursing interventions should be based on the client’s cognitive status, as well as current living arrangements.


INSTANT FEEDBACK:
Nurses working with adults with Down syndrome should tailor nursing interventions to the client’s cognitive level.
True
False

Developmental: Clinicians play a key role in maintaining and even enhancing the functional status of adults with Down syndrome, and should:

Many times, health care providers don’t have access to relevant developmental information; some clinicians simply ignore this portion of the client’s care. Nurses working with the adult may be in the best position to get the ball rolling on developmental issues.


INSTANT FEEDBACK:
Speech and language learning plateaus as the individual with Down syndrome enters adulthood, and further therapy is a waste of time and money.
True
False

Recommendations: NDSS incorporates the following thoughts in the health care guidelines:

Nurses working with the adult can facilitate communication between the primary health care provider, medical specialists, and agency staff involved in the care of the adult with Down syndrome. By providing relevant information in a timely manner, the nurse can make sure that the NDSS recommendations are addressed.


INSTANT FEEDBACK:
Health care providers working with adults with Down syndrome have a good grasp of the client’s social and developmental issues, so the nurse does not need to be involved in these areas.
True
False