Question

Baby girl Skylar is a neonate who was born at 37 weeks of gestation via cesarean section 1 hour ago. Her mother is a 34-year-old gravida 3, para three whose pregnancy was complicated by gestational diabetes mellitus. Baby Skylar weighs 4,196 g (9 lb 4 oz). The nurse notes that Baby Skylar is jittery, feeding poorly and exhibiting tremors.

Critical Thinking Questions 1. What is the priority nursing diagnosis at this time? 2. What is the expected outcome associated with the priority nursing diagnosis? 3. Describe the teaching/learning needs related to the scenario that corresponds to the priority nursing diagnosis. 4. List nursing interventions with rationales that correspond to the priority nursing diagnosis.

Answer 1

1.Tremors are a sign of hypocalcaemia. Diabetic mothers tend to have decreased serum magnesium levels and could cause secondary hypoparathyroidism in the infant.

Risk for tremors and secondary hypoparathyroidism in newborn born to diabetic mother .

2 The infant will be able to relieve from tremors.

3.Newborns of diabetic mothers may benefit from early feeding as they are extremely valuable in maintaining normal metabolism and lowering the possibility of such complications as hypoglycemia and hyperbilirubinaemia.

4.Nursing interventions are

• Obtain a blood calcium level. Rationale(R) - it helps in assessing blood calcium levels in the body of newborn.
• Check the newborns temperature. R-Assessing the vital signs helps in understanding the babys present health condition.
• Obtain a bilirubin level. R-Hyperbilirubinaemia can cause a raise in bilirubin level and cause tremors.
• Place a pulse oximeter on the newborn. R-it helps in assessing the oxygen saturation and the respiratory status of the baby.