HELP!!! NCP on neonate with PKU

[ingrid_212]

Hi, im a nursing student in Canada and for my theory class I have to write a nursing care plan on a 2-week old neonate wIth PKU (phenlyketonuria). That is all the information I have been given and I have to come up wit 4 nursing Dx and 3 interventations for each Dx. I just need some judgement on the Dx Ive come up with so far and whether they are good for my case study.

1. Delayed growth and development r/t cognitive impairment secondary to PKU (got that frim a post from daytonite)

2. Deficient knowledge of caregiver r/t complexity of dietary requirements secondary to PKU

3. Deficient fluid volume r/t vomiting

4. Impaired skin integrity r/t eczema and perineal rash.

PLEASE HELP...............ALL ADVISE IS GREATLY APPRECIATED!!!!!!

[Daytonite, BSN, RN]

when you have to do care plans on cases like this the first thing you have to do is look up everything you can find about the disease, its pathophysiology, signs and symptoms and complications. the next thing you need to do is find the normal behavioral milestones for a 2-week old baby because assessment information needs to be included.

this is the sequence the diagnoses need to go in:

1. deficient fluid volume r/t vomiting
   
2. impaired skin integrity r/t eczema and perineal rash.
   
   • can't use eczema as a related factor because it is a medical diagnosis. it really is more of a symptom or description of what the impaired skin integrity (broken skin) is. the related factor (r/t) is where you explain why the skin is impaired.
     
   • describe the eczema and perineal rash in more general medical language and they are the symptoms for this diagnosis.
     

[*]delayed growth and development r/t cognitive impairment secondary to pku (got that frim a post from daytonite)

[*]deficient knowledge of caregiver r/t complexity of dietary requirements secondary to pku

• if the care plan is for the infant i would change this to risk for caregiver role strain r/t developmental delay and complexity of dietary requirements to get the focus back onto the infant although the interventions would be aimed at the caregivers. as the diagnosis stands now, it focuses on the parents, but the parents are not the patient.
  

[ingrid_212]

Thank you for that. At 2-weeks old babies are not doing very much just eating and sleeping for most of the day. They can be startled by loud noises and during waking hours they do try to focus on objects. Im not sure what type of assessment to do.

Ive tried to fixed of my Dx: Impaired skin integrity r/t dry, itchy red skin with small bumps secondary to eczema and perianal rash.

is that better?

All the websites say about the same thing for signs and symptoms of PKU, am I on the right track with this or is there something I should be focusing a Dx on?

[Daytonite, BSN, RN]

impaired skin integrity r/t dry, itchy red skin with small bumps secondary to eczema and perianal rash.

dry, itchy red skin with small bumps

is not the cause of

impaired skin integrity

. it is the evidence of it. did you look up eczema? it is often just called dermatitis. what caused the perianal rash? the cause of eczema is not always known, but the cause of a perianal rash is usually moisture and humidity. that information can be found in most baby care books.

this is the diagnosis:

impaired skin integrity r/t moisture and humidity secondary to eczema and perianal rash aeb dry, itchy red skin with small bumps.