nursing assessment


Week 2/Discussion 2/ my post

 While conferenceing and examining a 17-year-old virile, you make-notorious a unspotted botch on his buccal mucosa and slanting palpebral fissures in his eyes. He too states during the conference that he plays baseball and is hoping to achieve an powerful lore to nursery.

When the 17-year-old boy says he plays baseball and would approve to get an powerful lore for nursery, we can augur that he spends a lot of opportunity in the ground, defenseless his headsecure to sun and has been defenseless to smokeless tobacco which is usual in the baseball fun. An extensiond use of smokeless tobacco use in funs, largely in baseball is been reported  in 2016 (Jarvis, 2016). ), “Leukoplakia is unspotted unspotted, numerous high-minded botch delay courteous-defined borders.”  This is established firmly to the buccal mucosa, flush if you scraping distressing it gain not follow off. You can too see it in exceptional who are heavily tobacco user as courteous as alcohol (Jarvis, 2016). Unspotted botches in the perforation too mentiond enormous Candida you may see it in resigned delay powerless immune scheme, steroid inhaler user, and HIV poison, use of broad-spectrum antibiotics, leukemia, and malnutrition.Slight upward or downward slanting of palpebral fissures normally occurs on a familial baseation or in groups such as persons of Asian depth. So in this fact the slating obvious fissures in his eyes base during the toll can be augur that this resigned is Asian or is an Asian depth. In non-Asians, the palpebral fissures are vapid (Jarvis, 2008). Usually when narrowed, upward slanted palpebral fissures are bestow it could be right of Down syndrome. In this fact this 17-year-old boy should feel been firm out precedent than the age of 17. I would induce a cranial strength experience using Snellen chart experience for visual acuity to see if there are any deficits in the optic strength. Patients neighboring anticipation could too be assessing (Jarvis, 2016).  An ophthalmoscope ask-advice-of should be assign to “examine the visible fundus to mention the hue, dimension, and outline of the optic disc” (Jarvis, 2016, p. 644). I gain too get prescribe for a CT review to government out ICP  if during retina exam  patient’s margins of the optic disc befollow blurred and imperfect. I would primitive lack to initially augur that the resigned has papilledema, too notorious as a choked disc which is an extension in cranial influence (ICP) (Jarvis, 2016).

As a Sanity trouble professionals we are traind and serviceable on strategies to train resigneds and source members environing this mood. Primitive and primary, would be for the resigned to feel genetic experienceing effected to ratify a Down syndrome diagnosed. If the experience results are actual, then the sanity trouble professional can collect the source and resigned delay the divert media and particular professionals to aid them in coping delay their new individuality. The one most leading invention that a sanity trouble professional can do is to warrant the resigned and source. This can be civil by carrying out intrusions in a kind in which source members earn a discernment of repress balance their own efforts to as their needs. Sanity trouble professionals can too strengthen families by creating opportunities for source members to befollow further suitable and headstrong-sustaining delay i-elation to their abilities to mobilize their collective networks to get their needs met and reach desired goals (Cohen, 2013). It is leading to too let the resigned distinguish that his troubleer of frank baseball may be poor in nursery may grossing decrease if other rights of mood sets in posterior in activity.

       Some exceptional meditateations that can succor to train the resigned and source on sanity furtherance and sickness intrusion would embrace natural monitoring metes, including every-year audiologic toll and every-year ophthalmologic toll, ongoing treatment of right of the disprescribe and connected moods, as courteous as argument of issues verified delay the propose into adulthood. If it were make-knowned that the resigned has familiar the association of using smokeless tobacco, I would train him on the hurtful goods of smokeless tobacco such as the extension endanger for cancer, and suffer him to search out metes to relinquish.  I would too remind him that at the age of 17 it is unfair to gain to tobacco products and that he could jeopardize his chances of frank baseball on the collegiate flatten via an powerful lore if caught violation the law. Furthermore, I would suffer this resigned to search resource mete to relinquish smoking, and choose up sanityier associations approve chewing sugar clear gum in assign of using smokeless tobacco.


Cohen, W. I. (2003). Sanity Trouble Guidelines for Individuals delay Down Syndrome-1999 Revision. Down Syndrome, 237-245. doi:10.1002/0471227579.ch17

                      Jarvis, C. (2016). Physical experience & sanity toll. (7th ed.). St. Louis: Elsevier.

                     Jarvis, C. (2008). Pocket mate for natural experience and sanity toll. (5thed.).  St. Louis:  Elsevier.


For our 1st pt-

The individuality of flagellatelash is a key differential individuality for our primitive resigned. When we meditate the resigneds complaints; HA, decreased ROM in the neck, vertigo, dropping of hearing to one ear, exudation and insuppressible eye proposements, concurrently delay the late potential arrangement of injury; the MVA flagellatelash does fit a potential individuality for this resigned. When we consider of the causes of flagellatelash, we consider of a vigor secure sufficient to flagellate the resigneds neck awkward and progressive, placing a august market of emphasis on the neck muscles and ligaments. What appended differential individuality is divert for our primitive resigned, inveterate on the S/S?