Down Syndrome Nursing Diagnosis and Care Plan

The newborn may experience difficulties with their mental and physical development as a result of this additional copy, which alters how their body and brain grow.

Even though some individuals with Down syndrome may act and appear alike, each one has unique skills. People with Down syndrome typically have mild to moderate low IQs (a measure of intelligence) and speak more slowly than other children.

Numerous impairments are permanent and might reduce life expectancy. But even those with Down syndrome can lead happy, healthy lives.

There are numerous options to assist in overcoming the obstacles associated with this illness, thanks to recent medical advancements as well as institutional and cultural support for people with Down syndrome and their families.

Types of Down Syndrome

• Mosaicism

“Mosaic” is a term for mixture or combination. Some of the cells in children with mosaic Down syndrome have three copies of chromosome 21, while other cells have the standard two copies. The characteristics of other Down syndrome children may also apply to children with mosaic Down syndrome. However, because some of them have cells with a typical number of chromosomes, they might have fewer symptoms of the illness.

Children with this kind of Down syndrome only have an additional portion of chromosome 21. This happens when an extra chromosome 21 is present, but it is not a separate chromosome 21; rather, it is attached or “translocated” to another chromosome.

Signs and Symptoms of Down Syndrome

Babies with Down syndrome typically exhibit some distinguishing characteristics at birth, such as:

• Flat facial features
• small head and ears
• Short neck
• Bulging tongue
• Eyes that slant upward
• Atypically shaped ears
• Poor muscle tone
• Tiny white spots on the iris of the eye
• Small hands and feet
• A single line across the palm (palmar crease)
• Small pinky fingers that sometimes curve toward the thumb

The development of a kid with Down syndrome is slower than that of a child without the disorder, even if they are born at an average size.

Commonly, minor to moderate developmental disabilities are seen in people with Down syndrome. Delays in the child’s mental and social development could indicate:

An infant with Down syndrome can be born of average size but will develop more slowly than a child without the condition.

People with Down syndrome usually have some degree of developmental disability, but it’s often mild to moderate. Mental and social development delays may mean that the child could have:

• Impulsive behavior
• Poor judgment
• short attention span
• Slow learning capabilities

Causes of Down Syndrome

In every instance of conception, both parents contribute genes to their offspring. Chromosomes contain these genes. Each of the baby’s cells is expected to receive 23 pairs of chromosomes, totaling 46 chromosomes, as it develops. The mother and father each contribute half of the chromosomes.

One chromosome fails to split properly in children with Down syndrome. Instead of two copies, the newborn has three copies of chromosome 21 or an additional half copy. As the brain and physical characteristics grow, this additional chromosome presents issues.

Risk Factors of Down Syndrome

Physical characteristics and developmental difficulties that can emerge in people with Down syndrome are caused by the extra copy of chromosome 21.

Researchers are aware that one extra chromosome causes Down syndrome, but they are unsure of the exact reason or the multiplicity of contributing factors.

The mother’s age is one factor that raises the chance of having a kid with Down syndrome. However, the majority of children with Down syndrome are born to mothers under the age of 35 because there are many more births among younger women.

Women who are 35 years of age or older when they become pregnant are more likely to have a pregnancy affected by Down syndrome than women who become pregnant at a younger age. According to research, a father’s age also matters. Fathers over 40 had a twofold increased risk of having a kid with Down syndrome.

In addition, the following parents are more likely to have a child with Down syndrome:

• People with a family history of Down syndrome
• People who carry the genetic translocation

It’s important to remember that none of these factors means that a couple would have a baby with Down syndrome. However, statistically and over a large population, they may increase the chance that they do.

Complications of Down Syndrome

• Congenital heart defects
• Hearing loss
• Poor vision
• Cataracts
• Hip problems, such as dislocations
• Leukemia
• Chronic constipation
• Sleep apnea
• Dementia
• Hypothyroidism
• Obesity
• Late tooth growth, causing problems with chewing
• Alzheimer’s disease later in life

Additionally, infection risk is higher in those with Down syndrome. They might have trouble with skin infections, urinary tract infections, and lung infections.

Diagnosis of Down Syndrome

• First Trimester. Blood testing and an ultrasound examination can check for Down syndrome in the fetus. Compared to tests performed at later stages of pregnancy, these tests show a higher likelihood of false positives. After the 15th week of pregnancy, the doctor might perform an additional amniocentesis if the results aren’t normal.
• Second Trimester. A quadruple marker screen (QMS) with ultrasonography can help detect Down syndrome and other brain and spinal cord abnormalities. This test is performed between 15 and 20 weeks of pregnancy. The fetus is at high risk of having birth abnormalities if any of these tests come back abnormal.
• Additional Prenatal Tests
  • Amniocentesis. The doctor collects an amniotic fluid sample to count the chromosomes in the unborn child. Typically, the test is performed at 15 weeks gestation.
  • Chorionic villus sampling (CVS) To examine the fetal chromosomes, the doctor will extract cells from the mother’s placenta. This test is performed between the ninth and fourteenth weeks of pregnancy. It can raise the risk of miscarriage by less than 1%.
  • Percutaneous umbilical blood sampling (PUBS, or cordocentesis) Blood will be drawn from the umbilical cord, and the doctor will check it for chromosomal abnormalities. This is done after the 18th week of pregnancy. This test is only done if the other tests are inconclusive because of the higher risk of miscarriage.
  • Test at birth. At birth, the doctor will:
  • Perform a physical examination of the newborn baby.
  • Order a blood test called a karyotype to confirm Down syndrome.

  Treatment for Down Syndrome

  Although there is no treatment for Down syndrome, there are numerous support and educational initiatives that can benefit both those who have the disorder and their families. Interventions begin in their infancy with the services that are currently available. Counseling programs for eligible families are also widely available.

  • Sensory skills
  • Social skills
  • Self-help skills
  • Motor skills
  • Language and cognitive abilities

  Children with Down syndrome often meet age-related milestones. However, they may learn more slowly than other children.

  Regardless of intellectual aptitude, attending school is a crucial component of life for a child with Down syndrome. Public and private schools provide integrated classrooms and special education options to serve individuals with Down syndrome and their families. Students with Down syndrome benefit from great socializing opportunities at school and develop critical life skills.

  Living with Down Syndrome

  • People with Down syndrome are now living far longer than they once did. In 1960, a child born with Down syndrome frequently did not live to see their tenth birthday. Today, people with Down syndrome can expect to live an average of 50 to 60 years.
  • To successfully raise a child with Down syndrome, parents need to develop a close working relationship with medical experts who are familiar with the particular difficulties this disease presents. Along with more serious issues such as leukemia and heart disease, people with Down syndrome may need to be protected from common infections such as colds.
  • Nowadays, more than ever, people with Down syndrome lead longer, more fulfilling lives. Even though they frequently experience a particular set of difficulties, they may nonetheless go through those.

  Nursing Diagnosis for Down Syndrome

  Nursing Care Plan for Down Syndrome 1

  Nursing Diagnosis: Delayed Growth and Development related to impaired ability developmental tasks secondary to Down syndrome as evidenced by activity restriction and environmental and stimulation deficiencies.

  Desired Outcomes:

  • The patient will be able to respond and react to environmental stimulation.
  • The patient will be able to express interests in people and activities that surround him or her.
  • The patient will be able to show interest in attending a school that is as free of restrictions as possible.
  • The patient will be able to interact and communicate with his or her family members.

  Nursing Care Plan for Down Syndrome 2

  Nursing Diagnosis: Self-Care Deficit related to cognitive impairment secondary to Down syndrome as evidenced by an inability in dressing, bathe, eat, and toilet.

  Desired Outcome: The patient will be able to safely accomplish self-care activities to his or her utmost capability.

  Nursing Care Plan for Down Syndrome 3

  Nursing Diagnosis: Impaired Verbal Communication related to impaired receptive or expressive skills secondary to Down syndrome as evidenced by difficulty verbalizing words and difficulty in maintaining communication skills.

  Desired Outcomes:

  • The patient will be able to use methods that will help him or her communicate clearly which will help in meeting his or her needs.
  • The patient will be able to participate and join speech therapy which will help him or her to have effective communication.

  Nursing Care Plan for Down Syndrome 4

  Nursing Diagnosis: Risk for Infection related to decreased muscle tone and poor drainage of mucus secondary to Down syndrome.

  Desired Outcomes:

  • The patient will remain free from infection and will not display signs and symptoms of infection.
  • The patient will be able to maintain normal vital signs and will maintain body defenses.

  Nursing Care Plan for Down Syndrome 5

  Nursing Diagnosis: Imbalanced Nutrition: Less Than Body Requirements related to increased metabolic needs secondary to Down syndrome as evidenced by inadequate caloric intake and difficulty chewing and swallowing.

  Desired Outcome: The patient will be able to take an adequate amount of calories or nutrients that the patient needs for normal growth.

  Nursing References

  Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier. Buy on Amazon

  Gulanick, M., & Myers, J. L. (2022). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon

  Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2020). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier. Buy on Amazon

  Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier. Buy on Amazon

  Disclaimer:

  Please follow your facilities guidelines, policies, and procedures.

  The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes.

  This information is intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment.

  Anna Curran. RN-BC, BSN, PHN, CMSRN I am a Critical Care ER nurse. I have been in this field for over 30 years. I also began teaching BSN and LVN students and found that by writing additional study guides helped their knowledge base, especially when it was time to take the NCLEX examinations.