Question

Baby A is a male infant born at 34 weeks gestation to a diabetic mother. He weighed 10 lbs 2 oz at birth and was a spontaneous vaginal birth. He is now 2 hours old. He has a large caput, facial bruising and apgars were 6 and 8. What nursing interventions are a priority with this baby? Why? What potential problems could he experience?

Answer 1

Baby A is considered as pre - term ,as he born before 37 weeks of gestation .His birth weight is slightly higher as mother was diabetic (normal birth weight is 7.5 lb - 10 lb).Caput and facial bruising are a common consequence of vaginal birth particularly with stressful passage through the the birth canal.Both the conditions will settle in few days.His APGAR at one minute was 6 ,which indicated that he might had required some assistance for breathing (normal APGAR at one minute should be between 7 - 10).APGAR at 5 minutes is 8 , which is normal , indicating he is doing well outside the mother's womb.

Priority Nursing Interventions for Baby A:-

1. Provide respiratory support.

Provide supplimentary oxygen through oxygen hood or face mask according to the physician's order.Suctionig can yield the airpassages clear . Pre- term babies are deficient of surfactants ( surfactant is a liquid made by the lungs to keep the airway open ) ,also have immature lungs that impaired gas exchange.Administer Surfactants as per the order will improve lung compliance and helps to prevent respiratory distress syndrome in premature babies.

2. Maintain neutral thermal environment.

3. Monitor and record vital signs.

4. Provide adequate fluids and nutrition according to the physician's order.

5. Maintain hand hygiene and practice sterile techniques while doing procedures to prevent infections.New born will get infections easily specially pre term babies.

6.Changing position every 2 hourly or according to the hospital policy will improve blood flow to the lungs .

7.Promote parent - new born bonding.

8.Administer other medications as per order .

Potential problems : -

1. Pre term babies often require special care in neo natal Icu's,as they face breathing difficulties, feeding problems, jaundice etc .

2 . Higher risk for re-admission to the hospital , as they are very prone to get infections.

3. Potential risk to develop respiratory distress.Breathing problems are very common with pre term babies and are at increased risk for asthma later .

4. Pre mature babies have immature brains ,brain is the last major organ to mature in babies .The immature brain continues to develop even after the birth .This situation may lead to mental retardation, visual and hearing impairments etc.

5. Learning difficulties later in life.

6. Behavioural and social emotional problems in the long run.

7.May require early intervention and special education services.

8.Baby A was born from a diabetic mother ,so he may get hypoglycemic after birth ,also diabetes and obesity later in life .