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help with infant failure to thrive care plan

by dnt85 dnt85 (New) New

I'm working on a care plan for an infant who has been diagnosed with failure to thrive. I only need one nursing diagnosis but I'm not sure which to pick... imbalanced nutrition: less than body requirements or delayed growth/development. I have to state 3 goals and 7 interventions with rationales. Any suggestions?

Jolie, BSN

Specializes in Maternal - Child Health. Has 35 years experience.

The nursing diagnosis that you choose as your first priority will be based upon your assessment of the infant. I realize that you may not have had a chance to examine and interact with the baby yet, so you may be forced to rely upon the information provided to you in your patient summary.

What is the baby's age, length, weight and head circumference? What is the baby's typical oral intake? What is the baby's sleep/wake pattern? What developmental milestones has the baby achieved? These are all important bits of information that are needed to determine which nursing diagnosis is most appropriate.

Daytonite, BSN, RN

Specializes in med/surg, telemetry, IV therapy, mgmt. Has 40 years experience.

when anyone is diagnosed medically with failure to thrive it is usually because they are malnourished. read about and look up the symptoms of malnutrition. see if this patient has any of them. diagnosing follows a very set regimen of assessing and then analyzing the data. a diagnosis is picked based upon the signs and symptoms that the patient has. the nursing process is the tool we use to do that because it is a problem solving method and care planning is merely problem solving. this thread on the student forums was started to help with writing care plans:

delayed growth and development would not be appropriate to use if this baby is failing to thrive. nutrition and eating is more important to focus on. interventions will target and treat the symptoms that the patient has. goals are the predicted results you expect to see as a result of your interventions being performed.

I went with the imbalanced nutrition but I'm having a hard time coming up with realistic goals since I only had two days with the infant... weight is a big issue because he is 8 months old and only weighs 14 pounds.

Daytonite, BSN, RN

Specializes in med/surg, telemetry, IV therapy, mgmt. Has 40 years experience.

i went with the imbalanced nutrition but i'm having a hard time coming up with realistic goals since i only had two days with the infant... weight is a big issue because he is 8 months old and only weighs 14 pounds.

imbalanced nutrition what? less than body requirements? what is your related factor? the reason that this has occurred? an inability to eat enough or not getting enough to eat in the first place? and why is this happening? what medical problem is at the bottom of all this? are there congenital anomalies going on that mean this baby will never feed normally? that is important information that is going to affect nursing interventions. what are the signs and symptoms of this imbalanced nutrition? not eating enough is not the only symptom. nanda lists these as the defining characteristics of imbalanced nutrition: less than body requirements:

  • abdominal cramping
  • abdominal pain (babies express pain by crying)
  • aversion to eating
  • body weight 20% or more under ideal
  • capillary fragility
  • diarrhea
  • excessive loss of hair
  • hyperactive bowel sounds
  • lack of food
  • lack of information
  • lack of interest in food
  • loss of weight with adequate intake
  • misconceptions
  • misinformation
  • pale mucous membranes
  • perceived inability to ingest food
  • poor muscle tone
  • reported altered taste sensation
  • reported food intake less than rda (recommended daily allowance)
  • satiety immediately after ingesting food
  • sore buccal cavity
  • steatorrhea
  • weakness of muscles required for mastication
  • page 148, nanda-i nursing diagnoses: definitions & classification 2007-2008

nursing interventions are of 4 types:

  • assess/monitor/evaluate/observe (to evaluate the patient's condition)
  • care/perform/provide/assist (performing actual patient care)
  • teach/educate/instruct/supervise (educating patient or caregiver)
  • manage/refer/contact/notify (managing the care on behalf of the patient or caregiver)

since the child is below ideal weight, one of your interventions is going to be regular weighings. you also might want to be assessing for some of the signs and symptoms of continuing "imbalanced nutrition: less than body requirements" by looking at ones you feel are pertinent from the listing above, such as dry mucous membranes. i would have the parent start out with keeping a food diary so an analysis can be made of just how much the baby is eating which can be correlated with a weight that was taken. then, a diet can be set up for the parent to follow. perhaps the caregivers need education. perhaps you need to bring a dietician or speech therapist (if there are swallowing problems) in to consult. goals can then be figured out from that: either no further weight loss or a moderate weight gain of 1 pound in a few weeks, determination of a diet that the parents will follow by the end of a specific period of time, remaining free of specific signs and symptoms of malnutrition, etc.

I was told that it was always important to think about ABC's, Maslow, physical and psychosocial and actual and potential when formulating nursing diagnosis. Delayed and development is more of a psychosocial nursing diagnosis so Imbalance nutrition would come first when prioritizing nursing diagnosis. Hope thi helps :-)

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