Need help with OB nursing diagnosis

  1. 0
    I'm in Ob right now. I was assigned a patient who was post op day 2 c-section with a hx of Bipolar Manic Disorder. Newborn was born at 37 weeks 5lbs 8oz. Here is my silly question, would I be able to use a nursing diagnosis as:

    Risk for SIDS r/t parental mental illness

    Ugh!! does that make sense or should scratch that?

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  2. 7 Comments...

  3. 0
    Risk for SIDS isnt a nursing dx- SIDS would be a medcial Dx, i believe. Also, from what i know about SIDS, its r/t respiratory, not parental mental status.

    Who are you writing the dx for? mother or baby?
  4. 0
    Quote from ThinkRNin2009
    I'm in Ob right now. I was assigned a patient who was post op day 2 c-section with a hx of Bipolar Manic Disorder. Newborn was born at 37 weeks 5lbs 8oz. Here is my silly question, would I be able to use a nursing diagnosis as:

    Risk for SIDS r/t parental mental illness

    Ugh!! does that make sense or should scratch that?
    Your post was moved to its own thread in the hope that it will receive a better response.

    As a postpartum nurse, I would not use this nursing diagnosis. There is not a clear-cut SIDS risk associated with having a bipolar mother.

    Some questions that might help you to decide on a good diagnosis--

    Is mom breastfeeding?
    Will she be taking psych meds?
    Does she have help with the newborn?
    How does she feel about the child?
    Does she have ongoing psych treatment?
    Does she have something in place to help her determine if she is becoming depressed? This is especially important in light of the possibility of postpartum depression.

    These are just starting points.

    I'm sure other folks will be able to suggest more ideas.
  5. 1
    nursing diagnoses are always based upon abnormal symptoms that you discover during the assessment of the patient not on their medical diagnoses. always. first of all, this is a surgical patient! so, she has a surgical incision that needs attention and monitoring. she is also subject to complications of either general anesthesia or epidural anesthesia, depending on which type she had! if she is a failed labor, then there will be some tissue trauma related to labor. is this mother breast or bottle feeding? if she is breastfeeding, there is a nursing diagnosis for it even if all is going ok. what about baby care? what teaching needs to be done?
    TDub likes this.
  6. 0
    Quote from daytonite
    nursing diagnoses are always based upon abnormal symptoms that you discover during the assessment of the patient not on their medical diagnoses. always. first of all, this is a surgical patient! so, she has a surgical incision that needs attention and monitoring. she is also subject to complications of either general anesthesia or epidural anesthesia, depending on which type she had! if she is a failed labor, then there will be some tissue trauma related to labor. is this mother breast or bottle feeding? if she is breastfeeding, there is a nursing diagnosis for it even if all is going ok. what about baby care? what teaching needs to be done?
    thank you everyone.

    i just figured i would be able to use risk for sids b/c it's listed in my sparks and taylor nursing diagnosis. in my book it's listed as risk for sids but with no indication of r/t. my clincial instrutor is expecting 3 nursing diagnosis for mom and baby. i was trying to apply this to baby. mom is bottlefeeding she is bonding with baby and yes she is on meds: risperdal and zoloft. also, she has, in the past, been admitted to the psych unit for treatment (breakdown).

    thanks again for your advise and help.
  7. 0
    Mom:
    Pain
    altered family process
    risk for infection
    Skin integrity, Impaired

    Baby:
    *Ineffective development of relationships
    *Ineffective pattern of giving and receiving
    *Ineffective pattern of dependency and independency
    Breastfeeding, Effective
    Breastfeeding, Ineffective

    These were just some areas that could be explored in your assessment. Some of these are Roy model diagnoses.
  8. 0
    Couple more nusing diagnosis suggestions for the mom:

    fatigue
    activity intolerance
    impaired mobility
    risk for fluid volume deficit
    risk for ineffective tissue perfusion
    knowledge defict
  9. 0
    babies are wrapped in blankets because their body temperatures are unstable. this is a problem that you can careplan for with every newborn--ineffective thermoregulation. they also, unless they are aliens from another planetary species, have an umbilical cord connection which is at risk for infection. and, finally, if you just put the baby down and do nothing else for it, what will happen? it will die or get eaten up by a predator! so, if you can't find anything else, the baby is at risk for injury due to a need to be cared for. if your baby has an elevated bilirubin and is under the bililights use risk for injury r/t phototherapy. you do an assessment of the baby to determine nursing problems just like you do the mom. if some nursing procedure is being done on the baby or the mother, that should tip you off that there is an underlying nursing "problem" that you just haven't identified yet, so go back to your assessment to see what you missed.


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