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Mrs. V, a healthy 45-year-old woman, gives birth to a child. There are no outward complications associated with the birth but, when examined by the pediatrician, the child exhibits abnormal facies, a single palmar crease, hypotonic muscles, and loose pelvic joints.

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 Exercise One:

Mrs. V, a healthy 45-year-old woman, gives birth to a child. There are no outward complications associated with the birth but, when examined by the pediatrician, the child exhibits abnormal facies, a single palmar crease, hypotonic muscles, and loose pelvic joints. Following chromosomal analysis, a diagnosis of Down syndrome is made.

Discussion Questions (Provide answers based on evidence and reference your responses using APA format)

1. Discuss the cause of Down syndrome.

2. What risks factors exist in the family history? Why are these thought to be risk factors?

3. Discuss further characteristics that the child may show as he gets older.

Exercise two:

Charlie is a 3-year-old in a community preschool. The staff reports that he tends to put everything in his mouth and is frequently found eating dirt. A home visit by a school staff member to discuss the problems with his parents reveals a generally clean environment in a very old home that was being renovated. Recently, Charlie has been falling behind in academic skills compared with the other children in his class; his linear growth has slowed, and he is tired and irritable. His physician noted pallor and what look like “pencil lines” on the gums adjacent to his teeth. He ordered blood tests, which revealed a low hemoglobin level and an elevated lead level.

Discussion Questions (Provide answers based on evidence and reference your responses using APA format)

1. Based on the patient history, signs and symptoms, and lab test results, discuss the probable environmental factors responsible for Charlie’s ingestion of lead.

2. Discuss the other toxic effects of lead poisoning that Charlie might experience if the situation is not addressed.

3. Discuss other possible sources in children’s environments that have been identified as containing lead.

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