Question

Patient/Family Interview/Teaching Assignment

. Development, implementation and

evaluation of one of the following options, including individual and family assessment, nursing

diagnoses, interventions and evaluation of outcomes: 1) home visit of relative, friend or

acquaintance who has had a newborn approximately one week of age, 2) in-hospital interview

/teaching to a selected patient and family (if feasible), opportunity that arises that is similar to

one of the above options (such as evaluation of movie that displays family dynamics after a

recent delivery, etc.).

Answer 1

HOME VISIT OF RELATIVE, FRIEND OR ACQUAINTANCE WHO HAS HAD A NEWBORN APPROXIMATELY ONE WEEK OF AGE

                                                                                                                            

Individual and family assessment

Baby

1. Physical assessment and history collection

· Relevant history collection, physical examination, growth charts, milestone developments, etc.

· Ask about the feeding patterns

· Assessment of growth and development (weight gain)

· Check for hyperbilirubinemia

Mother

1. Breast

· Assess for signs of mastitis

2. Bowels and bladder

· Constipation, dietary habits

· Urinary symptoms- urgency, frequency

3. Belly

· Assess and treat pain

· Incision- significant discharge or bleeding, or becomes red or painful.

4. Bleeding

· Lochia

5. Mental Status

· Baby blues/post partial depression

· Enquire about mood, social adjustment, and family adjustment at every visit

6. Birth control

· Barrier methods, IUD, progestin-only pill, or depot medroxyprogesterone if desired.

7. Blood work

· serum TSH

· CBC and Ferritin – History of Anemia

· Oral glucose tolerance test- history of gestational diabetes

8. Habits

· Use of tobacco, alcohol, and other substances.

Nursing diagnoses, Intervention and evaluation of outcomes:

1. Risk for ineffective breastfeeding related to lack of knowledge or inadequate dietary intake

Assessment

· Assess mothers willingness to continue or discontinue breastfeeding practice

· Assess support systems such as family members, friends etc.

· Asses potential milk supply for the child

Intervention

· Encourage and educate the importance of adequate fluid intake

· Encourage to take rest and good sleeping papers

· Educate the mother about abstinence to smoking or drinking habits if indicated

· Advice to take caffeine in low moderation if indicated.

Outcome or evaluation

· Mother comprehended the effectiveness or benefits of breastfeeding

· Realize the signs of reduced milk supply

· Mother collects breast milk with proper and safe practices

2. Potential for Parent or child attachment related to mental stress or fatigue or postpartum complications

Assessment

· Asses the physiological and cognitive health of the mother

· Assess or observe the bonding between mother and child

· Assess for any signs of postpartum blues or depression

Intervention

· Enquire about concerns related to parenting skills and teach parenting skills

· Provision of follow-up home visit if any symptoms indicated.

· Encourage family members to help with household chores and intense care for mother and baby.

Outcome or evaluation

· Increased bonding between mother and child

· No symptoms of postpartum depression or stress

· Evidence of accountability, coping abilities and role satisfaction

3. Risk for family coping related to newer parenting roles

Assessment

· Assess family and cultural background

· Assess or enquire the coping abilities compared to the past

· Assess support systems such as parents, friends etc.

Intervention

· Assist to set realistic goals for the couples for better coping abilities

· Discuss the amiable resources in the community for external support

· Encourage to seek support during adjustment problems.

Outcome or evaluation

· Family integration and parenthood satisfaction

· Evidence of role flexibility in the family

· Evidence of best decision-making abilities