Health Case History: Down Syndrome And Moderate Intellectual Disability

People with lifetime and chronic diseases experience various medical complications, and it might be risky to their lives if there are not nursing interventions to manage their conditions. This paper is focusing on a 45-year-old man who suffers Down syndrome, moderate intellectual disability and type II diabetes. These are health conditions that need a lot of medical concern. Otherwise his life will remain to be in danger. For example, an individual who suffers Down syndrome is prone to other diseases such as skin and bladder infections. This is according to the case studies that has been performed to people with Down syndrome and it has been discovered that their immune system is always low.

In addition around half of the population having Down syndrome may experience heart diseases, thus affecting their respiratory systems. Around 10-15% of the children diagnosed with Down syndrome are said to experience heart diseases that require surgery interventions and research shows that the chances of survival for these victims are between 0.8-0.9 (Chicoine & McGuire, 2010). Therefore, some other health challenges that might be experienced by victims of Down syndrome include Leukaemia, Thyroid, Hearing problems, Vision issues, sleeping problems and dementia among other psychiatric cases. Research shows that the probability of a child suffering Down syndrome to suffer hearing problems is above 0.8, thus making it a point of concern for the paediatricians among other physicians (Chicoine & McGuire, 2010).

An individual suffering moderate intellectual disability experiences issue related state of the mind. Therefore, several abnormalities are observed, especially that are related to the coordination or the mind and the other body parts. For instance, the intelligence quotient level for such kind of people always ranges from 35 to 49 (Horn, 2011). Therefore, according to the IQ scale chart, these values are for the individual whose intelligence under the borderline. Such individual requires a lot of care concerning methods of keeping them informed on how to undertake life’s activities. Some other health cases include developmental delays and little ability to communicate among other social problems. The man will also experience health issues related to Type 2 diabetes that will worsen his medical state. These medical problems include frequent urination and increased thirst, increased hunger, weight loss, fatigue, blurred vision, areas of darkened skin and frequent infections (Munshi et al., 2016).

The activities and participation of this man are negatively affected by his medical conditions that need several nursing and health interventions to provide support. Based on the International Classification of Functioning, Health and Disability, this man needs critical support because there is a significant effect on his normal body functioning. It can be stated that the immune system of the patient is disabled because it is unable to provide sufficient support to the body against diseases. Therefore, several infections will be observed that might raise discomfort in life and the involved activities. Some of the diseases that might be experienced include bladder and skin infections. Heart defects are among other health problems that might be experienced by the people suffering from Down syndrome and diabetes (Horn, 2011). 

Heart and thyroid abnormalities that might be experienced affects the normal functioning of the body, leading to several body dysfunctions such as breathing and irregular hormone production. Also, the effectiveness of the eyes and ears is reduced leading to related personal and social issues. Impaired learning for children and adolescent can be caused by sleeping disorders among other psychiatric problems. This is also caused by the reduced intelligence level caused by moderate intellectual disability, which might lead to mental illness for the rest of his life. Reduced ability to communication and inability to learn and understand effectiveness are among other problems that might affect the functioning of this man suffering such diseases.

As a result of Type 2 diabetes, other issues might be experienced such as frequent urinations leading to increased thirst. This indicates that the normal functioning of the bladder is affected, and there is a need for medical intervention(s). Increased hunger is experienced because the body does have enough insulin that moves sugar into the blood cells. Therefore, as a result of deprived sugar levels in the body, fatigue might also be experienced. The inability to metabolise glucose in the body, the victim will experience weight despite the fact that a lot of food is taken. The effect of reduced immunity, the victim will experience a slowed healing of sores or frequent infections into the body.

Type 2 diabetes requires a lot of nursing care before of the criticality of the health condition. If there are not effective nursing interventions implemented, the patient might live in discomfort because of failed support and control. The nursing intervention to be discussed in this paper will focus on the required physical activities and diet-related control and health support (Franz & Wylie-Rosett, 2007). The physical activities I will undertake as a nursing will be preventive measures against other infections or discomfort to the living standards of the patient. Therefore, the rationales of the nursing interventions will be aimed at ensuring that the patient is living comfortably in his environs. Also, the diet interventions used will focus on balancing the nutrition of the patient for better body immunity (Begg, 2011).

The risk of infection for a patient might include raised glucose levels, UTIs, decreased function of the leukocyte, pre-existing respiratory infections and alterations in circulation among others. If the symptoms perceived to these health problems are observed, it will be an indication that the patient is experiencing extended health problems related to the persisting diseases. There are physical interventions that can be used to reduce the risk of infection for such medical issues. The aim of such medical interventions will be to make him understand that there is need of nursing assistance in such condition (Carpenito, 2009). Also, techniques that can be used to reduce chances of infection will be demonstrated to the other people who are supporting this man in daily activities. Following these nursing interventions will help in reducing the probability of the patient infecting other diseases that might be linked to the pre-existing health problems.

As a nurse I will observe some physical symptoms such as flushed appearance, fever, purulent sputum, would drainage and cloudy urine. This is because people showing such signs and symptoms might be admitted in medical centres because of the infections. Also, some infection such as nosocomial might be experienced if there is no effective health intervention undertaken. Promoting and teaching good hygiene will be profitable for the health condition because of the lowered immunity, thus reducing the risks/chances of cross-contaminations. I will also ensure that the processes of medication are kept free from bacteria among other microorganisms that might lead to infections. The importance of keeping asepsis is because the increased level of glucose in the blood creates a favourable development environment for bacteria, virus and other microorganisms (Begg, 2011).

There will be a great need of providing sufficient skin care for the patient by massaging and ensuring that the skin is kept dry. Ineffective skin care might raise the chance of infections and breakdown because the infectious microorganisms will thrive well in a mismanaged skin surface. Listening to the breathing sounds of the patient will help in identifying cases of respiratory diseases, thus developing an effective medical intervention for the perceived disease. Deep breathing and coughing are encouraged because it helps in ventilating the lungs, thus increasing the efficiency of breathing (Munshi et al., 2016). Also, developing an effective disposal of the sputum among other secretions will help in managing chances of other infections. Finally, I would encourage to intake diet foods and fluids to reduce the susceptibility of disease infections.

The patient should be weighed daily to observe the changes in weight, which shows the effectiveness of the diet plan. If the body condition is worsened, a better nutritional intake plan will be developed to help in improving the condition of the patient. The diet plan is very important because it contributes to improving the state of the body for the patient. Auscultating the bowel sounds will help in determining the efficiency of digestion, which might cause abdominal pains vomiting, nausea and bloating among other digestive problems. I will also use fluid containing nutrient because of the easy digestion and absorption. This will help the patient in managing the issue of nutrient deficiency in the blood. The best preference foods for the patient can be included in the diet plan to encourage him to eat and enjoy the meals. A ration of 3:1:1 should be used in the diet of carbohydrates, proteins and fats respectively to ensure that the foods are fairly balanced (Munshi et al., 2016).

In conclusion, patients suffering chronic diseases should be provided with effective nursing interventions to help them in maintaining a normal lifestyle. Also, cases of insufficient body functioning such as intelligence disability should be provided with sufficient support to help the victims receive fair treatment and assistance in their daily activities. Therefore, the living standards of the patients will be perfectly and more efficiently managed by managing their needs.

Begg, A. (2011). Practical Diabetes Care. European Diabetes Nursing, 8(2), 73-73. https://dx.doi.org/10.1002/edn.182

Carpenito, L. (2009). Nursing care plans & documentation. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.

Chicoine, B. & McGuire, D. (2010). The guide to good health for teens & adults with Down syndrome. Bethesda, MD: Woodbine House.

Franz, M. & Wylie-Rosett, J. (2007). The 2006 American Diabetes Association Nutrition Recommendations and Interventions for the Prevention and Treatment of Diabetes. Diabetes Spectrum, 20(1), 49-52. https://dx.doi.org/10.2337/diaspect.20.1.49

Horn, D. (2011). Mild to Moderate Intellectual Disability and Significant Speech and Language Deficits in Patients with FOXP1 Deletions and Mutations. Molecular Syndromology. https://dx.doi.org/10.1159/000330916

Munshi, M., Florez, H., Huang, E., Kalyani, R., Mupanomunda, M., & Pandya, N. et al. (2016). Management of Diabetes in Long-term Care and Skilled Nursing Facilities: A Position Statement of the American Diabetes Association. Diabetes Care, 39(2), 308-318. https://dx.doi.org/10.2337/dc15-2512