NDx and newborn

[Qtip]

Trying to write this ND for a newborn would love some feedback.

Mother is + GBS, baby was delivered by CS. No prolonged rupture but mother did have a slight fever during labor. I think I understand whats going on but don't love what I have been able to articulate on paper.

This also has to be a postpartum ND which I feel it is because the infection would manifest postpartum, but would have been acquired intrapartum., so I'm having my own internal conflict deciding whether my instructor will except it as a postpartum newborn ND or not. Opinions appreciated.

Risk for infection

r/t inadequate acquired immunity, environmental exposure, and maternal fever 2˚ + GBS mother

AWBMB Fever, respiratory distress, or unstable blood pressure

Obviously I would have a better case if delivered lady partslly.

[nurseprnRN, BSN, RN]

see, this is the problem when you fall in love with the sound of a nursing diagnosis, and then try to cram your facts into it. nursing diagnosis is like medical diagnosis in this regard: data first, diagnosis second. you wouldn't think much of a doc who came in, never having examined you, and said, "we're gonna put a cast on that leg, it's fractured," before you ever had any xray, huh?

so what you should do is go to your nanda-i 2012-2014 and look for nursing diagnoses that might fit, but you don't take them unless their defining characteristics to support the diagnosis actually apply to the baby. i'm just looking at mine right now and i can see some possibilities, but i have no data at all about the baby....and this is supposed to be a diagnosis of something affecting the baby, right? how?

[nurseprnRN, BSN, RN]

and what the heck is "awbmb"? are those the symptoms the baby is having?

[Qtip]

Yeah I understand what your saying but problem here is the baby is healthy I don't have any blatant symptoms to work with. Which is why I have a risk for, if I had some symptoms it would be much easier to write the dx. All newborns are a risk for infection as I understand from textbook which is why breastfeeding and erythromycin, etc. are encouraged, on top of that the mother is GBS + which on it's own puts the baby at risk. I really don't see how I'm forcing this one to work, but I do see how I'm forcing the NANDA related to's.

I also I generally try to go by what we (me and the nurse) were focused on or worried about during the day of care to write my dx. And for this baby along with normal assessments we were consistently checking her temperature and notified the pediatrician of the fact the mother had spiked a temp which i understand is a significant risk factor for the baby.

[Qtip]

As would be manifested by, similar to as would be evidenced by (AWBEB). For whatever reason our school has us using manifested.

[NicuGal, MSN, RN]

Risk for sepsis related to maternal GBS manifested by temp instability, respiratory distress, poor feeding/lethargy. And remember, newborns rarely present with a fever, they will drop their temp.

Babies born by C/S can still present with GBS...moms can have a small leak that isn't known and can become infected that way too.

[Esme12, ASN, BSN, RN]

YOur Mom is still a post op. What would you be concerned postoperatively with a newly vacated uterus? What would you look for? Would there be potential safety issues for the baby or Mom because of narcotic pain relief? What would you look for?