Help w/ Nursing DX

[Pat_Pat RN]

2nd year ASN student. I have a Careplan to do. I have to have three nusing DX. My patient was a 6 day old that was in the hospital for jaundice, it was resolving. The child had no other problems. Normal lady partsl birth. Seemingly caring mother and her boyfriend.

I'm just stumped.

Thank,

Patrick

[Daytonite, BSN, RN]

Is the mother breastfeeding? If so, how is this being accomplished? There are several diagnoses for breastfeeding. A diagnosis of Interrupted Breastfeeding might apply. How is the baby being bonded with it's parents? Was the mother discharged? If so, there can be Interrupted Family Processes or even Impaired Parenting because of the baby's illness and separation from the parents. What is the condition of their skin? The jaundice is an abnormal finding. What are the dangers of being under a bili-light? How can you care plan for that? Perhaps a Risk for Injury diagnosis? To use any of these diagnoses you need to have the supporting symptoms in the patient/family.

[Pat_Pat RN]

Mother is breastfeeding and in the hospital room with the child all the time.

Bili-lights being UV can cause eye injuries, couldn't they also cause skin damage?

You said this:

"How can you care plan for that?"

Perhaps I don't understand "Care plans" in the big picture. Can I "Plan for care" for anything that 'might' happen to this child?

One ND that I did come up with was "Risk for impaired liver function". is that feasible?

Pat

[Daytonite, BSN, RN]

if you go by nanda guidelines the diagnosis you would use is risk for injury r/t uv light therapy (aeb signs and symptoms of eye and skin injury caused by the uv light). you don't include that part i have in orange lettering as part of the nursing diagnostic statement, but you are always thinking about it in the back of your mind. in doing the interventions and goals for this diagnosis you would need to list out all the signs and symptoms that you can find that would be caused to the eyes and skin as a result of the uv therapy. then, your nursing goals are simply to prevent them from occurring. your interventions are limited. basically, they are to make sure the light is being applied correctly, that the proper protections to the skin and eye are being taken and that the baby is being monitored for these specific signs and symptoms.

as for two other nursing diagnoses for this baby, you might want to touch base with your instructor for some guidance on this. i am thinking that perhaps some of the "readiness for" diagnoses would be appropriate here. ob is just not my specialty. had i been with you in your clinicals, i would have urged you to pull a couple of blank care plans from the nursing station desk before leaving that day to use as a guide. something you could do is call back to the unit, identify yourself as one of the students who was there during the week and see if you can get one of the nurses to help you come up with some appropriate nursing diagnoses to use. i would check with your instructor before using this:

• readiness for enhanced family processes

[Pat_Pat RN]

Thanks for the help. I might get this figured out sometimes....

Pat

[nskoog]

Hello,

In my Nanda Book, there were several nursing diagnoses for neonate jaundice. It was under Hyperbilirubinemia..

-Disturbed Sensory perception: visual (infant) r/t use of eye patches for protection of eyes during phototherapy

-Imbalanced Nutrition: less than body requirements (infant) r/t disinterest in feeding because of jaundice-related lethargy

-Parent role Conflict r/t interruption of family life because of care regimen

-Risk for disproportionate Growth: infant: Risk Factor: disinterest in feeding because of jaundice-related lethargy

-Risk for Imbalanced body temperature: Infant: Risk Factor: phototherapy

-Risk for Injury: infant: Risk factors: kernicterus, phototherapy lights.

Nursing Diagnosis Handbook, 8th Edition: p.59. Betty J. Ackley & Gail B. Ladwig

Hope this helps:wink2:

-N. Skoog

[Pat_Pat RN]

Thanks! That is great, just what I was looking for.