New born nursing diagnosis

[virmon1]

I'm doing rotations in the OB department and I need to develop a nursing care plan for a new born. I need to come up with three nursing diagnosis and develop a plan of care for one of them. I have an idea of what I want to work with but I'm having trouble finding the correct nursing diagnosis.

Here is the information I have about the newborn:

1. Full term Patient was delivered by a vacuum-assisted c/s section.

2. Patient is LGA and mother's BMI >31

3. Patient can be either breastfed or bottle-fed but mother insist on trying to breastfeed before starting to bottle-feed the neonate. Patient is in emotional distress he has been unconsolably crying since he arrived to the nursery and when the patient was taken to see the mother and try to feed he continue to cry and wasn't able to latch to the breast.

So since patient was vacuum-assisted I was thinking that one of the nursing diagnosis could be birth trauma (intracranial hemorrhage) r/t vacuum-assisted delivery AEB patient was delivered by a vacuum-assisted c/s section.

The other nursing diagnosis that I want to use is risk for hypoglycemia r/t LGA AEB: this is where I'm having trouble with...

The other nursing diagnosis that I want to use is risk for nutritional imbalance (less than body requires) r/t insufficient caloric intake AEB neonate not being able to latch to mother's breast and mother insisting on trying to breastfeed baby before attempting bottle.

I just need some comments to see if I'm in the right path or are my diagnosis totally wrong.

[JustBeachyNurse, LPN]

I'm doing rotations in the OB department and I need to develop a nursing care plan for a new born. I need to come up with three nursing diagnosis and develop a plan of care for one of them. I have an idea of what I want to work with but I'm having trouble finding the correct nursing diagnosis.

Here is the information I have about the newborn:

1. Full term Patient was delivered by a vacuum-assisted c/s section.

2. Patient is LGA and mother's BMI >31

3. Patient can be either breastfed or bottle-fed but mother insist on trying to breastfeed before starting to bottle-feed the neonate. Patient is in emotional distress he has been unconsolably crying since he arrived to the nursery and when the patient was taken to see the mother and try to feed he continue to cry and wasn't able to latch to the breast.

So since patient was vacuum-assisted I was thinking that one of the nursing diagnosis could be birth trauma (intracranial hemorrhage) r/t vacuum-assisted delivery AEB patient was delivered by a vacuum-assisted c/s section.

The other nursing diagnosis that I want to use is risk for hypoglycemia r/t LGA AEB: this is where I'm having trouble with...

The other nursing diagnosis that I want to use is risk for nutritional imbalance (less than body requires) r/t insufficient caloric intake AEB neonate not being able to latch to mother's breast and mother insisting on trying to breastfeed baby before attempting bottle.

I just need some comments to see if I'm in the right path or are my diagnosis totally wrong.

1. Did the medical team in fact diagnose an intracranial hemorrhage? Birth trauma is not a valid nursing diagnosis according to NANDA-I 2013-2015. Birth trauma is a medical diagnosis.

2 the child does not meet the criteria or defining characteristics of imbalanced nutrition: less than body requirements

However ineffective infant feeding pattern (impaired ability of infant to suck or coordinate suck/swallow resulting in inadequate oral nutrition for metabolic needs) AEB inability up initiate or sustain an effective suck (mom wanting to try breast before bottle is a nonissue) r/t possibly oral hypersensitivity or neurological delta or impairment (if an ICH is diagnosed)

3Risk for hypoglycemia is NOT a valid nursing diagnosis according to NANDA-I 2013-2015. There is risk for unstable glucose level but your patient does not meet the definition

If you were care-planning the mother/parents there are quite a few potential diagnoses from domain 7 role relationships.

You have disorganized infant behavior --disintegrated physiological and neurobehavioral responses of infant to the environment AEB abnormal response to sensory stimuli (difficult to soothe), jittery, startles,feeding intolerances, irritable crying r/t immature neurological system (there is more associated with this diagnosis in the NANDA-I book)

There is also ineffective breastfeeding AEB infant resisting latching on, infant crying at breast, infant inability to latch on correctly r/t infant anomaly? Maternal anxiety? Poor infant sucking reflex?

There is also risk for neonatal jaundice d/t feeding pattern not well established, infant experiencing difficulty making transition to extra uterine life, neonate aged 1-7 days