Writing a OB/Newborn careplan that is due at midnight. Confused on which RN Dx to choose

Published

I have a careplan due at midnight tonight, I had been waiting for response from a teacher, or else I would have had more of this completed by now...

I had a pregnant woman at 38.5 wks who had a macrosomic baby that needed to be delivered via emergency C/S 3 days early (when she had a planned C/S) d/t her pregnancy induced hypertension and severe HA.

The baby was LGA at 10 lb 3 oz, 22 in long, 15.5 in head circumference and vitals all normal. In the OR, there were units of blood delivered in case the mother who was B-, Rh - and a G3 P2012. She had previous rh incompatibility and PCOD. only lost estimated blood of 800cc.

other than that she was very healthy and the baby was very healthy. I have to have 2 significant mother dx and one baby dx.

I was leaning toward following the ABCs (airway breathing circulation safety) as priority... and had risk for PE/DVT d/t C/S, risk for CVA d/t severe HA and PIH...and for the baby I had risk for hypothermia d/t LGA, macrosomic...but I am not sure if these are accurate NANDA Dx and I was told by my teacher to think more about the bleeding and what is most important that is happening. ...I am racking my brain and looking online for dx that fit but I don't feel I have enough data to clearly fit another dx and make it strong..

please help (quickly!)

Much thanks

Specializes in NICU, RNC.

The #1 dx for any postpartum mother directly after delivery is Risk of bleeding/hemorrhage. Also, there is another HUGE risk factor for any patient post surgery. Any idea what that other risk might be?

Risk for Ineffective thermoregulation is a great dx for any newborn. However, there is a specific risk that is applicable to macrosomic babies that you will have to be watching for. Any idea what that might be?

Good luck!

So I was thinking about this...risk for bleeding and risk for infection? Also, I was thinking hypoglycemia (Which is what I meant to write above, not hypothermia (oops!)) for the infant... but there is not a risk of hypoglycemia dx in my nanda manual...theres risk of confusion, risk for unstable blood glucose and deficient knowledge regarding pathophys of condition, therapy and self care...so may risk for unstable blood glucose?

Specializes in NICU, RNC.
So I was thinking about this...risk for bleeding and risk for infection? Also, I was thinking hypoglycemia (Which is what I meant to write above, not hypothermia (oops!)) for the infant... but there is not a risk of hypoglycemia dx in my nanda manual...theres risk of confusion, risk for unstable blood glucose and deficient knowledge regarding pathophys of condition, therapy and self care...so may risk for unstable blood glucose?

Bingo! Good job!

Gold star for sharing your thoughts so an expert can give you feedback!

Thanks for you help!

+ Join the Discussion