at a loss with maternity careplan please help

[tambareyne1]

Hi, I am new to this site and it looks wonderful, I am hoping someone may be able to help me here. I don't know why I am having such a problem with my maternity careplan but my nursing diagnosis book does not offer much as far as maternity/newborn.

My pt. is 19, speaks predominantly spanish, little english, receieved no prenatal care until 35 weeks, father not involved, lady partsl delivery, estimated AGA 40.2 weeks, breast/bottle feeding

baby boy, 7lbs 10oz, Apgar 5/9, bag and mask x3 breaths, circumcision

I know there must be a diagnosis out there pertaining to her lack of prenatal care, I just cant seem to find it. My professor also feels that babies should be breastfeed exclusively and not to do both as this will make it harder for the baby to take the breast. I have looked through evidence based articles to find support of this. I was wondering if I could bring this in with a diagnosis?

Nursing diagnosis for the infant, I've come up with some general like risk for infection (circumcision), temperature regulation..... but I know there are better ones out there for this pt. since there was hardly any prenatal care and the apgar of 5???

Any help would be greatly appreciated!! Thanking you all in advance!!

[CrunchyMama, ASN, RN]

Your prof is right about the breastfeeding issue. My 1st mom I took care of in clinicals was doing both and the careplan I wrote was At risk for constipation r/t formula supplmentation. Also, it can effect the breastfeeding process. I did an at risk for infection r/t circumcision. I wish we could talk them out of doing that but I suppose that's not our job. Perhaps Readiness for Enhanced Parenting? Anyway....good luck!

[aehart]

You could probably do ineffective coping r/t lack of education...blah blah blah...since she had next to no prenatal care. Or, r/t lack of social support since father is not in the picture. Risk for depression r/t lack of social support, lack of education, teenage pregnancy, etc....

[OCD_Mom]

In my NANDA book (8th Edition Nursing Diagnosis Handbook by Ackley & Ladwig ppg 180-187) Breastfeeding is covered.

Ineffective Breastfeeding:

r/t infant receiving supplemental feedings with artificial nipple or knowledge deficit

OR

Interrupted Breastfeeding:

(the r/t here seem a bit off but I think knowledge deficit could be applied here too)

I actually want to become a lactation consultant working with new mom's of NIC and ill peds patients. I am a HUGE supporter of breastfeeding like your instructor. There is the possibility of nipple confusion for a new baby, typically the breast takes a little more effort than a bottle to get the milk out of + there is no milk for a couple of days so many think the baby will starve and needs a bottle (not the case.) Also giving a bottle right away also prevents the mother's body for producing an adequate supply of milk especially if she plans on becoming the sole provider of nourishment to her baby. If you get an opportunity seek out a lactation consultant on some of these.

[tambareyne1]

risk for ineffective breastfeeding R/T infant receiving supplemental feedings with artifical nipple and mother's age is what I did wind up using for one, now I need to come up with two for baby..... Thank you and everyone else who posted.