nursing diagnosis for macrosomic newborn

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    I am doing my clinical rotation for OB right now and I need help with a diagnosis for a 9lb 9oz baby. Overall she is "normal". Her mother did not have gestational diabetes,the mom just tends to have big babies. I already used the ineffective thermoregulation,but I'd like to do a dx that is r/t the baby's size if there is one out there. Any ideas?thank u!
  2. 9 Comments so far...

  3. 1
    Quote from iloveavianna
    i am doing my clinical rotation for ob right now and i need help with a diagnosis for a 9lb 9oz baby. overall she is "normal". her mother did not have gestational diabetes,the mom just tends to have big babies. i already used the ineffective thermoregulation,but i'd like to do a dx that is r/t the baby's size if there is one out there. any ideas?thank u!
    bookstores have a careplan books for ob. so how about a trip to a bookstore? or look up in your textbook?
    rhondaa83 likes this.
  4. 0
    Quote from iloveavianna
    I am doing my clinical rotation for OB right now and I need help with a diagnosis for a 9lb 9oz baby. Overall she is "normal". Her mother did not have gestational diabetes,the mom just tends to have big babies. I already used the ineffective thermoregulation,but I'd like to do a dx that is r/t the baby's size if there is one out there. Any ideas?thank u!

    they might be at risk for hypoglycemia
  5. 0
    Quote from ms.rn
    bookstores have a careplan books for ob. so how about a trip to a bookstore? or look up in your textbook?
    when i did my ob rotation a few months ago i could not find a careplan book for ob. i tried border's and barnes and noble, those are the bookstores near me. i tried posting to the ob nurses forum to see if anyone could give me a title of an ob careplan book and they all responded that they didn't know of any that were still in print.

    hmmmmm??

    kelly
  6. 0
    yeah,we do have careplans for OB in some of the books in our nursing lab,but I thought I'd just ask in case anybody had an idea
  7. 1
    Quote from kcpctrn2b
    when i did my ob rotation a few months ago i could not find a careplan book for ob. i tried border's and barnes and noble, those are the bookstores near me. i tried posting to the ob nurses forum to see if anyone could give me a title of an ob careplan book and they all responded that they didn't know of any that were still in print.

    hmmmmm??

    kelly
    \\



    delmar's maternal-infant nursing care plans




    maternal infant nursing care plans




    maternal-infant care planning


    [b]well there you go. my ob textbook gave me enough inormation about complications related to macrosomnia babies that i was able t6o come up with care plan. being in nursing school is to be able to come up with care plans based on information, you dont want someone to feed you with informaiton.
    rhondaa83 likes this.
  8. 0
    thanks so much
  9. 0
    Quote from ms.rn
    \\



    delmar's maternal-infant nursing care plans




    maternal infant nursing care plans




    maternal-infant care planning


    [b]well there you go. my ob textbook gave me enough inormation about complications related to macrosomnia babies that i was able t6o come up with care plan. being in nursing school is to be able to come up with care plans based on information, you dont want someone to feed you with informaiton.
    thanks ms.rn! i wish i had these when i did my rotation. wonder why i couldn't find em in stores? i may get one for my final though. thanks for the links!

    kelly
  10. 0
    it's interesting that you would like to do a nursing diagnosis related to the baby's size. first of all, there is not nursing diagnosis for an large gestational age baby. secondly, nursing diagnoses are based upon the patient's response to their condition. so, unless this baby is responding unusually to being 9lb 9oz, then there is nothing more to diagnose.

    you should be posting on the student forums. your question about a newborn is asked frequently and this is the answer i give. see if you have the interventions listed on the website i have posted below for ineffective thermoregulation:
    think about what you know about the assessment findings of a normal newborn compared to an adult. what's different? for one thing newborns can't regulate their body temperature which is why we don't leave them exposed to the room atmosphere for very long with just a diaper covering them. that's ineffective thermoregulation r/t immature compensation for changes in environmental temperature. [seehttp://allnurses.com/forums/f50/newb...is-346647.html for information on thermoregulation of temperature in newborns and nursing interventions.] some newborns just have a few difficulties with excessive secretions in the respiratory track (the big hint here is that the nurses will keep a bulb syringe nearby the baby) so ineffective airway clearance can be used. they also have a stump from the umbilical cord hanging off their future belly button. do you? are they treating this cord stump? if it's inflamed or there are umbilical cord problems there is risk for infection, so you can use risk for infection r/t break in skin integrity at umbilical cord site ([color=#3366ff]risk for infection). if the baby has been circumcised that is another reason for a risk of infection. is this baby breastfeeding? if so, use effective breastfeeding. and, some babies just don't start feeding well at first by breast or bottle--it happens. these kids are imbalanced nutrition: less than body requirements r/t poor infant feeding behaviors ([color=#3366ff]imbalanced nutrition: less than body requirements).

    if the baby is under the bililight for hyperbilirubinemia the nursing diagnosis to use is risk for injury r/t phototherapy ([color=#3366ff]risk for injury).

    the underlined blue type are a weblinks to nursing diagnosis pages with nanda information and some goals and nursing interventions.
    for more help with writing care plans, see
  11. 0
    Even if mom is not a GDM, baby can still be @ risk for hypoglycemia. Many units have specific protocal for babies over a certain weight. It usually includes bedside glucose testing and early feeding. (Yes, w/the dreaded formula!)


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