- 0I am working on a care plan for a patient that had thick meconium staining and variable decels. The newborn was delivered vaginally and was reported to not have suffered MAS. My diagnosis is risk for meconium aspiration since there was not actual aspiration but I am stuck on interventions. I have notify doctor, notify respiratory, monitor FHR, and educate and encourage patient. I feel like im missing something. Please help..any and all input is appreciated!
- 0Oct 11, '13 by PawBobbyJust some things to consider. Since there was no noticeable meconium aspiration maybe the diagnosis should be "Risk of Respiratory Distress due to possible meconium aspiration".
I would change the intervention "monitor FHR" to monitor respiratory effort. oxygen saturation, and HR.
Change educate patient to educate parents.
I hope you do not think I am being critical.
- 0Oct 11, '13 by IrishIzRNQuote from Born2Care4AllThe scenario is based on me being the L&D nurse attending the delivery. So thats why I assumed risk.. I also considered fetal asphyxia based on the variable decels not exactly sure though
So baby is born...
What are the risks to baby if baby swallowed mec? Where would the mec go? What could happen with mec there? This is a "risk for" with great interventions possible.
- 0I agree there are multiple interventions for the newborn, however I can limited to the delivery only. Another person in my class is assigned the "nusery nurse" and those interventions would be part of their plan of care. This limitation is what's making me confused. My interventions would only be for during labor not after birth.
- 1Oct 11, '13 by IrishIzRNQuote from Born2Care4AllI agree there are multiple interventions for the newborn, however I can limited to the delivery only. Another person in my class is assigned the "nusery nurse" and those interventions would be part of their plan of care. This limitation is what's making me confused. My interventions would only be for during labor not after birth.
So even though baby is born...you are supposed to write the care plan as if baby isn't born?
- 0Oct 11, '13 by llg GuideIf you are the L&D nurse, you need to include all of the normal, routine diagnoses for a full term neonate. So start there -- with all the regular stuff that all newborns need in L&D.
Then, add any extra things related to the high risk aspects. What would you assess/do for a baby who had experienced intrauterine distress? The doctor/midwife reported that he/she didn't see any meconium past the vocal cords ... but what would you assess/do to be on the safe side (in case a little meconium had been aspirated but not detected by the MD/midwife at delivery?