Question

Nursing care plan for Chapter 41: Nursing Care of the Child With a Cardiovascular Disorder 1. Baby boy Ellis, 2 hours old, is being evaluated in the newborn nursery by the nursing staff. Findings include T 37°C; apical heart rate 140 bpm; respirations 58 breaths per minute; BP (arms) 70/47, (calves) 62/39; head circumference 34 cm; chest circumference 31 cm; length 48 cm; weight 2,700 g. The infant is crying. (Learning Objectives 1, 2, 3, 4, and 8)

Answer 1

Nursing care:
-Clear the airway to ensure adequate breathing. This is the first line treatment.
-Monitor the baby respiratory rate by the continous pulse oximeter.
- Look for baby skin color for cyanosis or pale skin which indicates poor oxygen supply to the blood.
- Provide humidified oxygen with headbox or nasal cannula.
- Maintain fluid and electrolyte by encouraging the mother to feed for the baby when they cry for extra nutrition.
- Encourage the mother and baby bond by supporting and caring for the baby.
-Provide support to the family to avoid fear.
- Follow doctors instructions correctly to avoid toxic events.
-Maintain baby body temperature to normal to avoid hypothermia.
-Apply special knowledge and skills to implement the evidence-based clinical practice.