rubella vaccine postpartum

[GingerSue]

when rubella vaccine is given postpartum

it is to prevent future problems from congenital rubella syndrome

for a fetus (first trimester)

so I'm trying to write a nursing diagnosis

Risk for abnormality of a future fetus related possible rubella exposure

- is there a better selection of words for the diagnosis?

thanks

[Daytonite, BSN, RN]

How about: Risk for Fetal Injury R/T transplacental transmission of viral disease?

[GingerSue]

thanks

I considered to use the word "injury" but wondered if that would be the best word

as I thought about congenital cataracts, sensorineural deafness, congenital heart defects, mental retardation, or cerebral palsy

so that's the reason I used "abnormality"

for these types of implications - would injury or abnormality be better?

Because it is a preventive measure, I thought that perhaps I should include "possible"

Is it a good idea to indicate the specific illness of concern - rubella?

[Daytonite, BSN, RN]

Ah, I see what you're getting at. Actually, I think NANDA is very flexible on the rule of language, especially when you venture into the area of anticipatory diagnoses. If your instructor will accept Risk of Fetal Abnormality then that's what I would use. I would think you might want to stick with "transplacental transmission of viral disease" or even "transplacental transmission of bacterial or viral disease" mainly because your "related to" item is always an etiology. While rubella is the cause, the bigger picture is that the reason is that the virus passed to the fetus through the placental membrane. Abnormalities can occur in other ways that don't involve passing through the placenta (i.e., genetic). At least, that's how I would reason that out.

[Daytonite, BSN, RN]

I forgot to add that the older NANDA language was to formulate an anticipatory nursing diagnosis as "Potential for . . ." Using "Risk for . . ." is the current way NANDA has suggested anticipatory diagnoses be written. I think that using the word "possible" anywhere in the nursing diagnostic statement severely limits what you can do with the goal, outcomes and nursing interventions with that particular diagnosis. With a "Risk for . . ." I would want to keep my options open for several different options of problems.

[GingerSue]

thanks

it is the situation of a mother's unknown rubella titer

and how to plan the next steps

have to determine her status

and then based on her titer

whether to give her the Meruvax 2

but this topic of vaccine is one of several

topics that I might try to include together in a more general nursing diagnosis

such as the mother who is Rh-negative with a new baby and we don't yet know the baby's status or if the mother is sensitized

both of these require screening, they are both risks (but in the case of rubella it is infection, in the case of Rh antibody it is not infection)