Essential Information

Because individuals with mental retardation have a broad range of function, it is essential to determine the patient's specific baseline in a number of areas.

1. How the patient normally communicates.

2. How aware they typically are of their environment.

3. What are their usual motor skills and level of activity.

4. What is the patient's elimination pattern? Constipation and urinary tract infections are common in the mentally retarded and often present with increased agitation or self-injurious behavior.

5. What are the patient's usual sleep pattern and appetite? Both may be disrupted with infectious and psychiatric disorders.

Many mentally retarded patients have multiple medical problems that, either directly or as a consequence of medication side effects, contribute to their acute problem. Therefore, it is essential to get a complete past medical history, an accurate list of medications and doses, and history of prior adverse reactions including allergies. Frequently used medications and associated side effects are shown in T.a.b.l„e... .3.0.2-2.. Often increasing use of prn medications is associated with changes in mental status. Finally, one should ask about the patient's visual and hearing status and the use of assistive devices such as glasses, hearing aids, dentures, and walkers. Nearly 60 percent of mentally retarded adults have significant visual impairments, and they are twice as likely to have severe hearing impairments as nonmentally retarded individuals.1 i2 It is not unusual for someone with hearing or visual impairments to become agitated or withdrawn if an assistive device is lost or malfunctioning.

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