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This is a discussion on Newborn Nursing Diagnosis in Nursing Student Assistance, part of Nursing Student ... I am a second year nursing student and am stuck on 4 nursing diagnosis for my patient. He is a 3...by stroj01 Jul 19, '12I am a second year nursing student and am stuck on 4 nursing diagnosis for my patient. He is a 3 week old and I was only able to be with him for approximately 15 minutes to do an assessment. His vitals were WNL for his age, his only problem was he was diagnosed with Herpes Simplex Virus yesterday. I would appreciate any help/suggestions for diagnosis that I can use for this patient.
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- Jul 19, '12 by Katie71275What do you know about HSV and the outcome for an infant?
- Unfortunately I know nothing and I think that is why I am having so much trouble. I don't learn that content until next semester and I believe that is why I don't know what nanda diagnosis to use. I know that they will have to be geared toward the mother and the only one I can think of is "knowledge deficit r/t transmission of hsv aeb infant testing positive"
- Jul 20, '12 by Esme12what is a newborn at risk for? even a healthy infant. how is the infant feeding? are they latching on? was this a vag birth? was the baby full term? what about mom? how is she with the baby? are they bonding? how does mom feel about the baby? how old is mom? is mom understanding what the diagnosis is indicative of? what learning does mom need to care properly for baby? is this her first baby?
thermoregulation in a newborn is a neurological system adaptation to extrauterine life. newborns lose body heat, and lose it rapidly, 4 ways because their neurological systems are not fully developed at birth:
- conduction (their warm body heat transfers to cooler objects that they come into direct contact with)
- evaporation from exposure of wet skin surfaces lost to the atmosphere
- convection (their body heats transfers to the air surrounding them)
- radiation (their warm body heat transfers to cooler objects around them)
active herpes simplex virus is associated with spontaneous abortion in the first trimester of pregnancy and an increased risk of preterm labor after 20 weeks’ gestation. if a patient has active herpes around the time of the estimated date of delivery, cesarean section is the preferred method of delivery. infected infants can develop the following signs and symptoms after an incubation period of 2 to 12 days: fever, hypothermia, jaundice, seizures, poor feeding, and vesicular skin lesions.
- increasing their metabolism and increasing use of glucose and oxygen (to generate more heat)
- this causes their respiratory rate to increase leading to respiratory distress
- leads to hypoglycemia
- leads to metabolic acidosis
- leads to vasoconstriction (as the body attempts to retain heat)
- increasing cold leads to the production of fatty acids that interferes with bilirubin transport and can lead to jaundice
what does the hsv diagnosis mean for the baby? (this is where google and doing your detective work will be required)neonatal herpes simplex - symptoms, tests, treatment
who | standards for maternal and neonatal care
the biggest thing about a care plan is the assessment. the second is knowledge about the disease process.
here are the steps of the nursing process and what you should be doing in each step when you are doing a written care plan: from daytonite (rip)
- assessment (collect data from medical record, do a physical assessment of the patient, assess adls, look up information about your patient's medical diseases/conditions to learn about the signs and symptoms and pathophysiology)
- determination of the patient's problem(s)/nursing diagnosis (make a list of the abnormal assessment data, match your abnormal assessment data to likely nursing diagnoses, decide on the nursing diagnoses to use)
- planning (write measurable goals/outcomes and nursing interventions)
- implementation (initiate the care plan)
- evaluation (determine if goals/outcomes have been met)
just like you need a recipe care to make a cake from scratch. a care plan is your recipe card to caring for your patient and what to look for while you are caring for them.
the biggies with all newborns are temperature and feeding. if there are problems with either of these (or baby has a diabetic mom), blood sugar will also be a concern. low temp and inadequate intake can use up blood sugar as the body uses it for fuel. diabetic moms have kids who are used to insulin bringing the blood sugar down. after birth, that insulin keeps on pumping for a little while and can send blood sugar plummeting.
another thing to keep an eye on is jaundice from hyperbilirubinemia.....common in babies more common in sick babies that may not be feeding well. what about the umbilical cord site? what would you look for there? if the baby is febrile fluid balance is distrubed. how many wet diapeer would baby need?
risk for infection r/t break in skin integrity at umbilical cord site aeb..........
ineffective thermoregulation r/t immature compensation for changes in environmental temperature
imbalanced nutrition: less than body requirements r/t poor feeding behaviors
infection r/t hsv infection aeb........
risk for alteration in fluid/nutrition r/t .......aeb........
i hope this helps.Last edit by Esme12 on Jul 20, '12
- Thank you for all of your time and guidance. This is wonderful information and will greatly assist me in my nursing care plans
- Jul 20, '12 by GrnTeafyi: "we aren't supposed to learn that until next semester" is probably not a good thing to think or say to an instructor:d. part of your assignment is to learn things on your own.
so consider going to the library and finding articles or a book on nicu nursing or perinatal nursing that addresses a baby with herpes. tell the librarian what you need and ask her to show you how to use the cumulative index of nursing and allied health literature (cinahl)-- the library probably has an online access contract-- to locate it. a few good nursing mag articles should really be helpful here.
- This is my first time using this, I unfortunately didn't know these were instructors that were answering my questions but thankfully they were very helpful in assisting me with the way I should think about this assignment. I am unfortunately stuck in a pediatric clinical while learning about geriatric and med surg in lecture. It is hard to find time with a full time job, 2 children, and being in full time summer classes to learn a lot of outside material and have already tried other resources with minimal help. That is why I found this site in hopes of some additional help which I have received. Thank you for your advice.
- Jul 20, '12 by Esme12We are happy to help. Google is also your friend. Many students just don't know how to start or start in the wrong place. Technically, I am not an instructor although I have been an educator in hospitals. I have issues with clinicals that are not con-current because it is difficult to assimilate the information. There is also a search box on the upper right hand side of the page type in what you want there and you will also get results.
We really are happy to help.
- Jul 21, '12 by GrnTeaI used to teach in nursing school but now feed my teaching habit on AN. We won't do anyone's homework for her even if she has a chaotic or demanding home life (about which we can all sympathize, truly) but share the philosophy that it's best for students to learn how to find info for themselves-- the old teach-a-man-to-fish thing. Hope these resources have been helpful in getting you there.Welcome to the profession!
- Jul 25, '12 by NurseMaybeBabyIneffective thermoregulation
Risk for injury
Knowledge deficit, newborn care
Risk for SIDS
Risk for infection
It would help if you knew a few more things. Is it a first time mom? GBS positive? Vaginal delivery?