need help with wording my intervention

uRNmyway, ASN, RN · Feb 20, 2014

Hmm, I see where you are going, although your rationale probably goes more with dehydration/fluid electrolytes.

First, BF q2h is ridiculous lol. Newborns are feed on demand as far as I know. Yes, you encourage mom to bf on demand. You assess property latch and technique. You offer support. You monitor baby for weight loss, wet/dirty diapers. Monitor VS. Temp being obvious, HR too.

My nursing school encouraged teaching to be part of the careplan, along with physical interventions. So yes, teaching could/should be part of the CP, depending on what your assessment showed. You assess how much your patient knows, and teach what they don't.

I think you were heading in the right direction, just need to expand on it all some more.

nurseprnRN, BSN, RN · Feb 20, 2014

I'm not seeing this as primarily an infection-prevention measure, either. Have you looked at the nursing diagnoses related to caregiving roles in the NANDA-I 2012-2014 (Domain 7, Role Relationships, p. 293)? There are several that are concerned with breastfeeding. You can also find breastfeeding-related nursing diagnoses in Domain 2, Nutrition, p, 171.

It sounds as if you are deciding on interventions before you have a diagnosis. :) This is why making you look at nursing diagnosis as a linear process, rather than a "let's start here and find justification for it" is what we teach. I think you're stuck because you need to step back a bit and figure out what your priorities are here. Do you see that this infant is at risk for infection (p. 417) d/t problems with breastfeeding or ... ? I'm not seeing anything in your post that indicates there is a risk for infection in this infant, nothing that appears on the list of risk factors for this diagnosis.

What is your evidence (defining characteristics) for that assessment? Are you looking for support for your premise that breastfeeding is best, and the nurse should do all possible to encourage and support it? (For the record, I spent almost 5 years in total breastfeeding my own babies, so I'm not being argumentative about that. I want you to look at why you want to make these diagnoses.) But for THIS baby and mother, I'm not seeing your basic premise. Risk for infection isn't it.

uRNmyway, ASN, RN · Feb 21, 2014

I'm not seeing this as primarily an infection-prevention measure, either. Have you looked at the nursing diagnoses related to caregiving roles in the NANDA-I 2012-2014 (Domain 7, Role Relationships, p. 293)? There are several that are concerned with breastfeeding. You can also find breastfeeding-related nursing diagnoses in Domain 2, Nutrition, p, 171.
It sounds as if you are deciding on interventions before you have a diagnosis. :) This is why making you look at nursing diagnosis as a linear process, rather than a "let's start here and find justification for it" is what we teach. I think you're stuck because you need to step back a bit and figure out what your priorities are here. Do you see that this infant is at risk for infection (p. 417) d/t problems with breastfeeding or ... ? I'm not seeing anything in your post that indicates there is a risk for infection in this infant, nothing that appears on the list of risk factors for this diagnosis.
What is your evidence (defining characteristics) for that assessment? Are you looking for support for your premise that breastfeeding is best, and the nurse should do all possible to encourage and support it? (For the record, I spent almost 5 years in total breastfeeding my own babies, so I'm not being argumentative about that. I want you to look at why you want to make these diagnoses.) But for THIS baby and mother, I'm not seeing your basic premise. Risk for infection isn't it.

Ah Grntea, this is why I should have left the answer to the expert lol. You are much better at the guiding thing than I am!!

nurseprnRN, BSN, RN · Feb 21, 2014

OP, how about some feedback? What do you think?