Thank you so much, Nathan. You brought up a few points I overlooked. Greatly appreciate the help!
Sandy -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Nathan Sent: Friday, February 06, 2004 2:25 PM To: [EMAIL PROTECTED] Subject: Re: Preterm infant Lord knows I know very little about peds, but here is my shot at it. General - Based on the brain damage, compare expected level of functioning for a two month old and the actual level. Respiratory - You can go back to the NANDA dx for some tips here. Nutrition - Does this baby take food/liquids by mouth. Be expecially careful to watch for aspiration if there is active respiratory issues. Hiccups that may occur after eating could be a serious issue here, especially if short-term post-op. Pulmonary Insufficiency/Patent Ductus Arterious/Ligated - Assess for level of activity tolerance and schedule activity to her ability (I am guessing the patient is female since PDA is more common in females. Assess cardiac status on a routine basis (heart sounds, peripheral perfusion, I&O, all the normal stuff). http://www.emedicine.com/emerg/topic358.htm Intraventricular hemorrage - Since you did not mention that the baby has Hydrocephalus, I assume that dx does not exist - it often develops after IVH. Assess for changes in cranial pressure (pupil changes, change in LOC, etc). Proper positioning may be important. I don't know if there are any hypertensive issues, but if so monitory closely as that will have direct impact on both the IVH and the cardiac problems. http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/hrnewborn/ivh.html http://www.babyzone.com/drnathan/I/Intraventricularhemorrage.htm Based on the dx of Periventricular Leukomalacia I would conduct regular assessments looking for the development of Cerebral Palsy. Some studies estimate 70-100% of all PL cases will develop CP. http://www.emedicine.com/ped/topic1773.htm Family - I can't even imagine the stress of the family. Call Social Services now and get them invovled. Facility - This is going to be a tough one since most of this child's problems are not really treatable. Watch for adverse reactions among staff of childbearing age, especially if they are pregnant, or have young children. Good luck. I don't envy you your job, but I am glad that someone is there to do it. Nathan ----- Original Message ----- From: "Sandy Howard" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Friday, February 06, 2004 11:16 AM Subject: Preterm infant > > Sorry folks, I realize most, if not all, of you are geriatric...But > just in case some one could help... I need some guidence on care > planning for a preterm (10wk early, is now two months) with Dx of: > Pulmonary insufficiencey, Patent Ductus Arteriosus/Ligated, > Periventricular Leukomalacia, and Intraventricular Hemorrage, grade 4. > Any ideas/ suggestions would be welcomed. Just found out he will be > coming Monday. > > Sandra Howard, RN > MDS/Care Plan Coord. > ChildServe Habilitation Center > 515-331-8155 > [EMAIL PROTECTED] > > /---------------------------------------------------------- > The Case Mix Discussion Group is a free service of the American > Association of Nurse Assessment Coordinators > "Committed to the Assessment Professional" > Be sure to visit the AANAC website. Accurate answers to your > questions posted to NAC News and FAQs. > For more info visit us at http://www.aanac.org > -----------------------------------------------------------/ > /---------------------------------------------------------- The Case Mix Discussion Group is a free service of the American Association of Nurse Assessment Coordinators "Committed to the Assessment Professional" Be sure to visit the AANAC website. Accurate answers to your questions posted to NAC News and FAQs. For more info visit us at http://www.aanac.org -----------------------------------------------------------/ /---------------------------------------------------------- The Case Mix Discussion Group is a free service of the American Association of Nurse Assessment Coordinators "Committed to the Assessment Professional" Be sure to visit the AANAC website. Accurate answers to your questions posted to NAC News and FAQs. For more info visit us at http://www.aanac.org -----------------------------------------------------------/
