respiratory distress in neonate

[smit6843]

I am in the process of making a care plan for a neonate who suffered respiratory distress after birth for at least the first 1 hours of life (I left clinical after this first hour and was unable to observe whether he began breathing normal..). He was 40 weeks gestation. The mother was induced. He delivered ROL with the cord around the neck. He was experiencing signs such as nostril flaring, grunting and chest retraction. He also had a temp of 100.1F.

I am searching for a Nursing diagnosis and I have a few in mind that I may be able to apply to this patient, but would like a few opinions as to what I should use.

The following are ones that I have considered using as a nursing diagnosis:

- Ineffective Breathing Pattern

- Ineffective peripheral tissue perfusion

Any suggestions?

[NRSKarenRN, BSN, RN]

Moved thread to Nursing Student Assistance for advice with care planning.

[NicuGal, MSN, RN]

Did mom have a fever? Was she treated for GBS? Any other risk factors?

Babies can transition for up to 4 hours with mild respiratory retractions, etc. but when you have a fever, which is very abnormal in a newborn, then you have an issue. Sometimes kids with a nuchal cord have some respiratory issues, but the clue is the fever.

[toya932]

I am not too sure here, being that I am only now starting in the fall. But I do remember learning about this once in A&P.

I'm thinking neonatal respiratory distress syndrome. Although this is more common in premature babies, it is possible to have to full term babies. RDS occurs when the child's lungs are not fully developed causing a lack of production of surfactant. All the signs you mentioned-- flaring of nostrils, grunting, are signs of this.

The major diagnosis factor is the child being premature, but as you mentioned, the child is 40 weeks. Other causes can be the mother having diabetes, a rapid labor, or decreased blood flow to the said child. So this can possibly be a diagnosis, if any of these things are true.

Again, I'm sorry if I am wrong, I am only now beginning, but I've been reading a lot. And I remembered learning about surfactant during A&P.

[NicuGal, MSN, RN]

Fever does not go with RDS :). GFR can be part of many neonatal problems.

[toya932]

NicuGal, I completely forgot about the fever part. Woops. Sorry about that :) In that case, scratch out my response.

[springchick1, ADN, RN]

Did the mother have her water broken and then not deliver for a while? Would that cause a fever in the baby if an infection was passed from the mother during delivery?

[NicuGal, MSN, RN]

Usually a newborn will have a fever because mom did. And yes, look at how long the membranes were ruptured.