Working on a case study for OB/ Peds

nurseprnRN, BSN, RN · Jan 28, 2013

You can't make a medical diagnosis, you're a nurse ( or will be). Medical diagnosis is found in the chart and is probably something like, "3 days postpartum, 39.7 weeks gestation, normal newborn." When they ask you for a medical dx, you look in the chart for it.

What are her behaviors suggesting for nursing diagnoses? Hint: check your NANDA-I 2012-2014 under coping and role. You do have the NANDA-I, right? If not, you can have it in two days, free shipping to students from Amazon. Get it stat. It will save your buns in care planning for the rest of your school and beyond.

KelRN215, BSN, RN · Jan 28, 2013

So here is the scenario- 22 year old female patient, P0G1, father unknown, currently dating.
She is not bonding with the baby, is displaying many postpartum issues. No attachment behaviors, ignores child crying reluctant to feed child, in general just disinterested in the baby.
The assignment is asking for a medical Dx, not sure what it would be. My interventions are based on promoting bonding and attachment (as well as seeking S.S. consult). It is the medical Dx that I am stumped on PPD would be an easy Dx but not really accurate. Also her vitals and physiology are good fundus firm 1” below umbilicus mod rubra breasts soft one day post.
Looking for suggestions for Dx.

You, as a nurse, do not make her medical diagnosis. You cannot "diagnose" post-partum depression. Her medical diagnosis is in her chart. You are on the right track with her nursing interventions but it's not in your scope to diagnose medically.

Dantastic · Jan 28, 2013

This is an assignment for class not an actual case that I can find a chart for. But the assignment asks for a medical Dx such as fetal alcohol syndrome or gestational diabetes...

Lanesmama · Jan 28, 2013

Make a medical diagnosis? We aren't doctors... and does your blurb mention anything about culture? For example Vietnamese women traditionally stay in bed for 10 days after the birth and grandmother/ or nurse took complete charge. They weren't ignoring their babies but following custom. So, if this were my patient, I would sit down with her and ask her why she isn't interested. Maybe it's culture, maybe it's because she doesn't know what to do... teaching

nurseprnRN, BSN, RN · Jan 28, 2013

This is an assignment for class not an actual case that I can find a chart for. But the assignment asks for a medical Dx such as fetal alcohol syndrome or gestational diabetes...

In that case you are free to make one up. :) Then find nursing diagnoses to fit your case study, because any case study in nursing school must include them. Else you are not learning....nursing.

Dantastic · Jan 28, 2013

This is an assignment for class not an actual case that I can find a chart for. But the assignment asks for a medical Dx such as fetal alcohol syndrome or gestational diabetes...

Dantastic · Jan 28, 2013

Sorry that re-posted when I was trying to refresh the page

KelRN215, BSN, RN · Jan 28, 2013

This is an assignment for class not an actual case that I can find a chart for. But the assignment asks for a medical Dx such as fetal alcohol syndrome or gestational diabetes...

Does the case study give you any information that leads you to believe this person has a diagnosis of gestational diabetes? Fetal alcohol syndrome could be a diagnosis in the baby but not in the mother and there's nothing in the info you posted that would lead us to make that diagnosis. Read the scenario carefully, there's probably something there and, if not, her medical diagnosis is something like "Full term pregnancy- delivered."

Lanesmama · Jan 28, 2013

So then why not PPD? -It can occur soon after birth- think of the hormones that rapidly dropping. She is a single mom, generally young now with a kid. Holy crap her life is changing all around her. Just because she is dating doesn't mean he is going to be supportive. s/s PPD include disinterest in baby, loss of concentration/energy, lack of pleasure. See: Postpartum depression - PubMed Health

nurseprnRN, BSN, RN · Jan 28, 2013

All true. However, since this is a hypothetical case study, you can say that she was seen by a psychiatrist or psychologist and diagnosed with this if you want to. The point is that YOU can't diagnose it.

For related nursing diagnoses, see your NANDA-I for Domain 7, Role relationships: class 1, caregiving; class 2, family relationships; class 3, role performance. You will find plenty of grist for your mill there.