Interventions for Impaired Parenting Dx

Nursing Students Student Assist

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I have been racking my brain for the last 2 days trying to come up with feasible, pertinent nursing interventions for for a diagnosis of Impaired parenting r/t young parental age AEB mother is 17, and still in high school. My pt. is 2 month old, premature, admitted for fever, hypoglycemia, dehydration, mother reported vomiting. She was supposed to be discharged the day before I cared for her as everything was back to WNL. She however was not d/t mom is 17, in high school, and had been kicked out of both parents homes. So, it is a social services case now, mom had all of her belongings at the hospital and was just kind of living there waiting for social sevices to make their decision. So, my pt. was no longer sick, although she was still very small (7lb at 2 months). I'm having a hard time with this careplan. My instructor said that my Dx were fine. My other 2 dx were risk for abnormal blood glucose r/t vomiting, and FVD r/t vomiting AEB abnormal lab values. I just can't seem to come up with any interventions for this one other than referring mom to programs for homeless mothers, or referring mom to programs for adolescent mothers. Please help with some ideas to get my brain moving in another direction. Thanks in advance!

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Specializes in med/surg, telemetry, IV therapy, mgmt.

well, i see one problem immediately. you say your patient is the 2-month old child, yet all your data for this diagnosis is about the mother! if the child is your focus, then your assessment and abnormal data needs to be about how the parenting problems are affecting the growth and development of the child. if you look at the defining characteristics for this diagnosis (i'm giving you a web link to a nursing diagnosis page with that information: impaired parenting) you will find specific things pertaining to the child and specific things pertaining to the parents. at the young age of 2 months i would imagine you are going to see failure to thrive (nutrition problems) frequent illness, attachment issues and possibly cognitive issues starting to develop. did you do an assessment of the child to determine that developmental milestones were being met? those can be found on a number of websites listed on the pediatric weblinks listed on this sticky thread:

https://allnurses.com/nursing-student-assistance/medical-disease-information-258109.html - medical disease information/treatment/procedures/test reference websites

  • fluid volume deficit r/t vomiting aeb abnormal lab values
  • impaired parenting r/t failure to thrive and illness aeb small weight for age (only 7 pounds at 2 months) [do you have a birth weight?][failure to receive medical care as soon as needed, did that happen here?] - what other information do you have that the mother contributed to the baby's illness and loss of weight in any way either by acts of omission or just not doing what needed to be done?
  • risk for delayed development r/t failure to thrive [with this diagnosis you are making a plan to prevent any further developmental delays. this will be your teaching plan for the mother to educate her in how to socialize with the baby. use those websites to help you out.]

or

  • ineffective health maintenance r/t inability of caregiver to make appropriate judgments aeb [could be evidenced by: inability of mother to take responsibility to meet the basic health needs of the patient, lack of knowledge of child care by mother and impaired personal support system of mother] [this gives you the source of the child's problems and a way to introduce your nursing interventions to correct for them. make sure the focus stays with how it affects the child]

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Thank you so much Daytonite for your help! I'm still going in 100 different directions with this careplan. As I said my pt. wasn't sick anymore when I began taking care of her. The only reason I am even using FVD Dx is because her lab values were abnormal 2 days before I saw her. Her chart didn't have newer values in them (U/A was cancelled for some reason). Her birthweight was 4 lbs, and all the info in the chart was very subjective. It was not the hospital she was born in, so the Hx contained a lot of things like "according to mother, baby was 2 weeks premature", and mother stated she brought her in after 2 episodes of vomiting. I did do an assessment, and baby had not met the 2 month milestone of being able to hold her head up when placed on her stomach. I do have a question about this. If the baby was born premature, is she still considered 2 months old as far as development goes? If she was born full term she would only be 1.5 months. When I spoke to my instructor she said my careplan should include caring for baby and mother, and include treatments for making mom comfortable as well as baby. I'm just so confused about all this, this is my first pediatric patient and class just started a few weeks ago so I'm still trying to grasp the developmental concepts. Thanks again!

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