Newborn Assessment: 1. An infant boy boy was born @ 3:13 pm vaginal delivery the 1 minute APGAR is 6 & the 5 minute APGAR is 7. The infant is transferred into nursery and has jittery, cyanosis (face, hand, and feet), shaking when he’s stimulated. Upon auscultation, the lungs are moist.
1. What action would you take with this infant?
2. What nursing interventions would you do for this patient by 4:15 pm?
3. At 24 hours of age the infant’s bilirubin level is 13.2. What would be the treatment plan for this patient? Would you transfer the infant to nursery or let the infant remain in the mother’s room?
4. Mom is trying to decide if she should get her infant circumcised.
a. What critical information does the nurse need to look for in the chart prior to the procedure?
b. How is pain managed for the newborn during this procedure?
c. Identify the patient teaching related to care of the circumcised newborn at home.
d. Identify the patient teaching related to the care of the uncircumcised newborn at home.
e. How would you respond to the mother when she asks your opinion about getting her son circumcised?
1. What action would you take with this infant?
2. What nursing interventions would you do for this patient by 4:15 pm?
By 4.15 pm, I would ensure that the baby's condition by monitoring the vital signs, oxygen saturation, repeating of blood sugar and APGAR score. If it is within normal, I promote the optimum bonding between the mother and baby.
3. At 24 hours of age, the infant’s bilirubin level is 13.2. What would be the treatment plan for this patient? Would you transfer the infant to the nursery or let the infant remain in the mother’s room?
It is normal for a newborn having a high bilirubin level after delivery due to various stress factors. It normally settles down and does not require any treatment. Phototherapy is recommended only if the bilirubin level is above 15mg/dL in the first 24 to 48 hours. So the newborn can remain in the mother's room.
4. Mom is trying to decide if she should get her infant circumcised.
a. What critical information does the nurse need to look for in the chart prior to the procedure?
The nurse should look for the consent of the mother for the circumcision procedure.
b. How is pain managed for the newborn during this procedure?
Analgesia is used for the safe effective management of pain. During the procedure, the newborn must be anesthetized using a local agent or topical anesthetist to manage and control pain.
c. Identify the patient teaching related to care of the circumcised newborn at home.
Teach the patient to look for a surgical site for infection or any signs of infection and to inform the physician immediately. Teach the parents to look for the pattern of urination and ensure for no bleeding. Make the child to be comfortable. Educate the mother to clean the area and to change the diaper most often.
d. Identify the patient teaching related to the care of the uncircumcised newborn at home.
If the baby is not circumcised, then the area has to be cleaned properly with mild soap and water. Do not pull back the tip of the foreskin. Once the child gets older, then the area has to be cleaned properly by pulled back and to clean. Educate the parents to watch for any discharges, bleeding, or swelling on the sites.
e. How would you respond to the mother when she asks your opinion about getting her son circumcised?
Circumcision is done based on the parent's wishes. Some may prefer due to health benefits, some followed due to cultural and religious practices, or for personal preferences. As circumcision is an elective procedure, one has to take a decision on her own.
Newborn Assessment: 1. An infant boy boy was born @ 3:13 pm vaginal delivery the 1...
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