Newborn careplan-Nanda Diagnosis Elimination

  1. Hello,
    I am a nursing student. I am stuck on a care plan. I have a newborn with a preliminary diagnosis of Transient Tachypnea of the Newborn. I am stuck on a NANDA diagnosis for elimination. This infant was 0-2 hours old when I was observing it. I am supposed to pick NANDA diagnosis for an infant who voided but has not yet has a stool. What would be an accptable NANDA diagnosis for elimination? I have been trying to figue this one out for a few days now.
    Thank You
  2. 7 Comments

  3. by   Coffee Nurse
    Do you have to choose an elimination-related diagnosis? For a kid with TTN who's not even three hours old, lack of stool would not even be on my list of concerns.
  4. by   rhoangel123
    Yes, we have a long assessment form which we are required to fill out, a section for each system. Elimination along with everything else requires a NANDA diagnosis. It can be wellness, risk for or actual problem such as constipation. After we come up with a NANDA for each system, we then choose the top two concerns and careplan those. I was thinking of choosing impaired gas exchange and possibly ineffective thermoregulation for my top two. The other systems are really stumping me.
  5. by   Coffee Nurse
    Maybe Risk for Dysfunctional Gastrointestinal Motility, i.e. necrotizing enterocolitis? Was the baby a preemie? Had they started feeding?
  6. by   rhoangel123
    The infant was 38 wks gestation, Repeat C-Section, forceps and vac assist dilivery. The Dr couldn't get infant out right away and amniotic sac was still over infants head. Infant swallowed fluid just before birth. It took a lot of suctioning to get airway cleared. Weighed 6 pounds 16 oz. Would not turn pink for a while. Apgars were 7 at 1 min and 9 at 5 mins. Required radiant warmer with Servo. My thought was, is it ever a problem with constipation due to stress right after birth? I am trying to figure if I should anticipate a problem or could do a risk for or wellness diagnosis. What do statistics show about an infant with transient tachypnea and ailementary or other systems besides respiratory and circulatory?
  7. by   rhoangel123
    By the way the infant was 2 hours old when I left the floor, had voided and was just starting to breastfeed.
  8. by   Coffee Nurse
    I was thinking about the fact that they might delay feedings secondary to the tachypnea and concerns about aspiration, but evidently that wasn't the case. I can't think of any connection between stress and elimination problems, either; if there had been a prolonged hypoxic episode after birth, the kidneys might have taken a hit, but Apgars of 7 and 9 don't suggest that. I think a wellness diagnosis might be in order.
  9. by   gatherswool
    Hmm....I'm a PNP, so my NANDA knowledge isn't too fresh, but I do work in a well nursery. A term baby with a difficult delivery and subsequent TTN will usually have the following issues:

    amnio-filled lungs
    immediate inability to feed due to tachypnea
    subsequent breastfeeding difficulties secondary to mom/baby separation
    feeding difficulties due to aggressive suctioning (oral defensiveness)

    The latter two could result in delayed stooling (not constipation). I have yet to see constipation in the normal newborn population; at least not in-hospital. If a baby gets formula instead of breastmilk s/he might eventually develop constipation, but any delay in stooling in the first few days of life is either related to inadequate intake, to narcotics for NAS, or to a more serious condition like an obstruction or Hirschsprung's. Birth stress doesn't cause constipation; if anything babies mec when distressed.

    Would it be cheating to list incontinence; total?
    (I'm only partly kidding; those diapers DO have to be changed!)

    Good luck, and I hope you enjoyed your newbie!