Assessment, Nursing Diagnoses and Interventions – Intellectual Developmental Disorder (IDD) (Nursing)

00:00 Now, we need to be able to assess this child for nursing care and usually the level of IDD is reflected in the child's IQ score. Now an IQ score, intelligent quotient score, is a psychological test that is given by a psychologist and it reflects a level of intellectual functioning. There have been a number of questions about IQ scores because those children who do not have the same backgrounds who may come from an impoverished academic background who doesn't use the same lingua as what is on the IQ test who may not be able to recognize some of the symbols because of not having that same amount of interaction with a greater world than the trials on small world maybe at a disadvantage and so sometimes when you're looking at an IQ score, we are thinking about it is not just the IQ score that is going to identify a child with IDD. However, the IQ score is used nationally and federally for any kind of social programs that you may want to be putting the child into. So we don't only go by the number of the IQ score, we also are assessing the child for how well that child can interact, how well that child can learn, and how well that child can engage in self-care. Now, it's important for us to know as nurses we do not diagnose a child with IDD, but we do assess that child. We do need to focus all of our intention on that child's strengths and capabilities rather than on their weaknesses and their inabilities. We also want to make sure that we are including the family and the community when we are taking care of this child. We want to ask ourselves while we're assessing this child "How independent is the child? What can this child do on his or her own? How well can that child communicate their need if they're hungry, if they're thirsty, if they're frustrated? What level of language does that child have?" And also "How physically able is this child to get around? Are there safety issues that we need to be aware of?" Always thinking safety, safety, safety, safety. It's always the answer in mental health nursing. A child who is impulsive might rush towards something because it looks nice even though it is dangerous. A child who is not able to make that intellectual connection between fire and burn, that child is at high risk. So, we think about, for our nursing diagnosis, risk for injury related to altered physical mobility perhaps, perhaps related to impulsive behaviors. Risk for injury is usually one of the nursing diagnoses that is the first that we're going to be thinking of for a child with IDD. And what outcome do we want? We want to make sure that there is no physical harm to that child while that child is our patient. What do you think another nursing diagnosis might be? If you're saying self-care deficit, you are 100% correct. These are children who may not be able to brush their teeth, these are our children who are in elementary school and still in diapers. This is a self-care deficit. A child with IDD may not be able to feed themselves or if they can feed themselves may not be able to make the choices of food that would actually keep them healthy and well. So what is the outcome that we want as far as nursing? Well, again we have to make sure that the child's needs related to their self-care are going to be met. So what's another nursing diagnosis? There are a number of them that we can identify, I think. These children may have ineffective coping. The world may be just too difficult for them to understand and so we are hoping to make them able to and to facilitate not just for them but their families and their community to facilitate demonstrating some adequate appropriate coping skills instead of, for example, having a tantrum when you are frustrated, being able to say "I'm going to sit down and count to 10." And maybe have their significant other or their caretaker sit with them and learn how to do this kind of appropriate coping skill. So there are others, I'm sure that you can think of other nursing diagnosis. As you go through nursing diagnosis, it's always good to keep in mind that these diagnoses are not connected with the medical diagnosis. What is the nursing diagnosis connect with? It connects with the patient. What is the patient's need? So how would the level of a child's functioning affect how we are going to intervene in giving care to that child and that child's family? So what are our nursing interventions for IDD? Our nursing interventions are to facilitate communication. Our nursing interventions are to keep the child safe and to work in open communications with the family and the community to be able to help the family negotiate with whatever schools and what other social interactions the child is going to be having to have functional and adequate coping skills for moments of frustration.