You are assigned to the mother–baby couplet unit. Your assignment for the day includes the Sanchez family. Margie is a 28-year-old G3 P2 who gave birth to a healthy boy, Manuel, at 8:39 AM. Margie experienced an uncomplicated labor of 12 hours. Membranes ruptured 7 hours before delivery. Manuel weighs 3800 grams and is 50 cm in length. His 1- and 5-minute Apgar scores were 8 and 9. Manuel is 2 hours old. The Ballard score indicate that Manuel is 39 weeks. Your initial shift assessment findings are:
Vital signs: Axillary temperature, 36.2°C; apical pulse, 100 beats per minute; respirations, 30 breaths per minute.
Skin is warm and pink with acrocyanosis.
Fontanels are soft and flat.
Molding is present.
Lung sounds are clear.
There is mild nasal flaring.
Manuel is in a sleep state and unresponsive to external stimuli.
Tasks:
1. Based on the above information, discuss the immediate actions for baby Manuel. Provide rationales for your actions. (10 points)
2. List down other significant assessment to baby Manuel. Explain your answer. (10 points)
Margie breastfed her son for 15 minutes on each breast but she stated that she is not sure that her newborn is “getting any milk”.
Tasks:
3. How do you respond to Margie? Explain your answer. (10 points)
4. Give the benefits of breastfeeding and list down the 10 steps for successful breastfeeding.(10 points)
5. What are the priorities for helping the newborn and his mother have a positive experience. List signs of parent-infant bonding. (10 points)
1) He is a full-term baby with a normal APGAR score. The main problem, which is evident from the given details, is that the baby is facing difficulty breathing, thus the presence of nasal flarings. His axillary temperature is slightly lowering. Normal = 36.5-37.5°C . Normal heart rate = 120-160 BPM. Normal respiratory rate = 40-60 breaths per minute. Everything is slightly lower in this case.
First, we have to prevent hypothermia. Warm and dry the baby.
Remove sections from mouth and nose, if any. New horns are nasal breathers. So if you block the nose, they are forced to breathe through the mouth, and chance for secretion in the mouth.
Position the airway. A slight extension of the neck
Tactile stimulation
If breathing becomes labored, give supplemented oxygen.
2. Other assessment:
Complete neonatal assessment by 2 hours of age
Complete gestational assessment as per hospital policy
Weigh and measure the head, chest, and length
Prevent heat loss by maintaining NTE.
3. Check for the reflexes. Especially rooting reflex. Check whether she has enough milk. If the baby can't be breastfed, supplementary nutrition must be provided.
4.
10 steps for successful breastfeeding
Critical management procedures
1a. Comply fully with the International Code of Marketing of Breast-milk Substitutes and relevant World Health Assembly resolutions.
1b. Have a written infant feeding policy that is routinely communicated to staff and parents.
1c. Establish ongoing monitoring and data-management systems.
2. Ensure that staff has sufficient knowledge, competence, and skills to support breastfeeding.
Key clinical practices
3. Discuss the importance and management of breastfeeding with pregnant women and their families.
4. Facilitate immediate and uninterrupted skin-to-skin contact and support mothers to initiate breastfeeding as soon as possible after birth.
5. Support mothers to initiate and maintain breastfeeding and manage common difficulties.
6. Do not provide breastfed newborns any food or fluids other than breast milk unless medically indicated.
7. Enable mothers and their infants to remain together and to practice rooming-in 24 hours a day.
8. Support mothers to recognize and respond to their infants’ cues for feeding.
9. Counsel mothers on the use and risks of feeding bottles, teats, and pacifiers.
10. Coordinate discharge so that parents and their infants have timely access to ongoing support and care.
Benefits of breastfeeding :
Lower risk of breast cancer.
Lower risk of ovarian cancer.
Lower risk of rheumatoid arthritis and lupus.
Less endometriosis.
Less osteoporosis with age.
Less diabetes.
Less hypertension decreases blood pressure.
Less cardiovascular disease
5. Signs of parent-infant bonding:
Touch becomes an early language as babies respond to skin-to-skin contact. It's soothing for both you and your baby while promoting your baby's healthy growth and development.
Eye-to-eye contact provides meaningful communication at close range.
Babies can follow moving objects with their eyes.
Your baby tries — early on — to imitate your facial expressions and gestures.
Babies prefer human voices and enjoy vocalizing in their first efforts at communication. Babies often enjoy just listening to your conversations, as well as your descriptions of their activities and environments.
You are assigned to the mother-baby couplet unit. Your assignment for the day includes the Sanchez family. Margarite is a 28-year-old G3 P2 Hispanic woman who gave birth to a healthy boy, Manuel, at 0839. Margarite experienced an uncomplicated labor of 12 hours. Membranes ruptured 7 hours before delivery. She received 2 doses of Nubain during labor. The last dose was given at 0440. Manuel weighs 3,800 grams and is 50 cm in length. His 1- and 5-minute Apgar scores...
You are assigned to the mother-baby couplet unit, where your patients for the day include the Sanchez family. Margarite is a 28 y.o. G3P2 Hispanic woman who gave birth to a healthy male, Manuel at 0839. Margarite experienced an uncomplicate labor of 12 hours. Membranes ruptured 7 hours before delivery. She received 2 doses of Nubain during labor. The last dose was administered at 0440. Manuel weighs 3,800 grams and is 50cm in length. His 1 and 5 mins Apgar...
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