Newborn CarePlan

[am0r803]

hi there,

doing a careplan for a newborn and so far i have risk for infection r/t umbilical cord site, and ineffective thermoregulation r/t inability to compensate for changes in environmental temperature. i wanted to do one with nutrition but not sure how to put it. the infant is on bottle feeding, and i know theres a diagnosis for effective breast feeding, can i put effective bottle feeding or no?

a little help please??

[513misslady]

Hey,

Altered feeding pattern/Ineffective feeding pattern or Failure to thrive.

Later

Misslady

[rn/writer, RN]

I wouldn't use the one about infection r/t umbilical cord site. In many years of taking care of kiddos, I've never seen it happen. Not once.

The biggies with newborns are temperature (which you rightly picked) and feeding. If there are problems with either of these (or baby has a diabetic mom), blood sugar will also be a concern. Low temp and inadequate intake can use up blood sugar as the body uses it for fuel. Diabetic moms have kids who are used to insulin bringing the blood sugar down. After birth, that insulin keeps on pumping for a little while and can send blood sugar plummeting.

One other thing we keep an eye on is jaundice from hyperbilirubinemia. At my hospital, nurses use bilimeters as a screening tool on the second day of life. We can also order a serum bili level at any time we feel a kid looks yellow or has enough risk factors (positive Coombs tests, large amount of bruising or cephalohematoma, Asian ethnicity, hx of siblings with jaundice, etc.) to merit the test. We are also responsible for phototherapy once it's ordered. This might be something you could work with.

Hope this give you a good starting place.

[Daytonite, BSN, RN]

use risk for infection r/t break in skin integrity at umbilical cord site. the risk factor is that if the cord comes off or is traumatically removed instead of falling off on its own it creates an open skin area which is the actual potential for infection as a result of open skin area.

for ineffective thermoregulation r/t immature compensation for changes in environmental temperature. see https://allnurses.com/general-nursing-student/newborn-nursing-diagnosis-346647.html for information on thermoregulation of temperature in newborns and nursing interventions. it has links to this website: http://www.who.int/reproductive-health/publications/msm_97_2_thermal_protection_of_the_newborn/msm_97_2_chapter2.en.html

you can use imbalanced nutrition: less than body requirements r/t poor feeding behaviors when babies don't start feeding well at first by bottle. just describe their fussiness with feeding, poor intake amount or other little problems that are going on.

[lovemypatients10]

I have a quick question..for a normal newborn..no complications would ineffective airway be the number 1 nursing dx? This was a test question and I chose thermoregulations but now I am kicking myself because of ABC...Thanks!

[rdsxfnrn]

unless the newborns breathing is compromised, your answer should be correct. b careful with the ABC ?????s, sometimes they just throw them in there as a red herring, as in this case.