Fetal/newborn priority careplan

[vancarr]

Help! I need to complete a care plan for risk for infection for a fetus. The mother has a history of chorioamnionitisand is GBS positive. I feel like I never get my related to and AEB right so I figured I would try it out here and you guys can help steer me in the right direction. Does this work? Risk for infection related to 48 hour labor as evidence by history of chorioamnionitis and GBS positive? Thank you in advance!

[SoldierNurse22, BSN, RN]

I'll be upfront with you--I haven't written a careplan since nursing school.

However, I can tell you that the GBS + status, 48-hour labor (I'm guessing the patient's water was also broken for an extended amount of time during said labor?), and history of chorio all are under the "r/t" section of your diagnosis.

A few questions:

1. In this scenario, is your mom already postpartum? Or is she currently laboring?

2. Does your scenario tell you how long the pt's water was broken in the course of that 48 hours? Especially if it's a new mom, labors can be long. While the labor length is a concerning factor for chorio, it's more about how long mom's membranes have been ruptured, how many times she's been checked, and whether or not her GBS has been treated.

3. Does mom have a history of chorio in this pregnancy or a previous one? I'm assuming it's this pregnancy since it was mentioned at all in your scenario.

4. Your AEB portion should contain physical symptoms displayed by the infant, lab values, culture results, and vital signs. Does baby have a fever? Is baby tachycardic? Are baby's counts elevated or cultures positive? Is baby irritable, having difficulty feeding, or are baby's blood sugars off? All of those are potential signs of infection.

Also, mom may have displayed signs of chorio during labor as well, which you could argue also belong under the AEB section, especially if baby is asymptomatic (which can happen). If mom had a fever during labor, tachycardia, purulent or foul-smelling amniotic fluid, a tender abdomen, etc, those also indicate an infection which presents a risk to baby.

Good luck! :)

[vancarr]

Thank you for responding! yes mom is currently in labor, she had SROM 24 hours prior to me starting my clinical. Her history of chorio is from a past pregnancy and she is GBS positive being treated with ampicillin for this current pregnancy. She had quite a few lady partsl checks and FSE placed on baby. And yes baby's heart rate was on the higher end. I see what your saying about being more specific I will work on clearing it up more! Thank you! :)