1 day old nursing dx's

GooeyRN, ADN, BSN, CNA, LPN, RN · Mar 28, 2009

Risk for skin breakdown re: urinary/fecal incontinence?

Alteration in nutrition re: (cause of low birth weight) as evidenced by inadequate subcutaneous tissue???

llg, PhD, RN · Mar 28, 2009

Why is he really in the isollette? That machine does not make him bigger ... it doesn't make him more mature ... etc. So, what service is the isolette providing him?

Think about it ....

It is keeping him warm. That's why they are called "incubators." He is at risk for poor temperature regulation, hypothermia, etc.

What else is he at risk for? Infection? Feeding difficulties? Jaundice? Impaired maternal-infant bonding? Does he have any indications of any of these things, or is he just at risk for them? Why is he of low birth weight? Is he premature and at risk for problems of prematurity? Was he under-nourished in utero? If so, why? and what problems could result from that?

"Low birth weight" by itself tells you almost nothing. You have to find out why he was small to know what his biggest risks are.

... and also consider this very real possibility. He may have no actual problems at all. He may simply be a little boy who was born a few weeks early or who has petite parents or who was a little undernourished in utero ... but who is actually perfectly healthy. Then, his only problems are the same as those of every other newborn -- except that he is separated from his mom and now living in a machine that might malfunction and over-heat him or let him get cold if the nurses don't monitor him well enough.

Daytonite, BSN, RN · Mar 28, 2009

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. [see https://allnurses.com/general-nursing-student/newborn-nursing-diagnosis-346647.htmlfor 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).

use risk for infection r/t break in skin integrity at umbilical cord site. the risk factor is that if the cord comes off or is traumatically removed instead of falling off on its own it creates an open skin area which is the actual potential for infection as a result of open skin area.

for ineffective thermoregulation r/t immature compensation for changes in environmental temperature.see https://allnurses.com/general-nursing-student/newborn-nursing-diagnosis-346647.html for information on thermoregulation of temperature in newborns and nursing interventions. it has links to this website: http://www.who.int/reproductive-health/publications/msm_97_2_thermal_protection_of_the_newborn/msm_97_2_chapter2.en.html

you can use imbalanced nutrition: less than body requirements r/t poor feeding behaviors when babies don't start feeding well at first by bottle. just describe their fussiness with feeding, poor intake amount or other little problems that are going on.

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).