Please read the following case study details. Then respond to the questions below.
You are a nurse caring for women and children in a rural clinic. This clinic serves most of the area’s population and provides comprehensive women’s healthcare. This includes things such as: postpartum care, newborn care, lactation, and clients of all ages.
Kristen has arrived at your clinic for Sawyer’s one week checkup and a postpartum check-in. Kristen’s ex-boyfriend is the father of the baby and continues to not want to be involved with the infant at this time until he can have a custody hearing.
Kristen states “My nipples are killing me, and breastfeeding is not going well! Sawyer looks a little yellow. Is that normal?”
Chicken pox as a child. UTD on all immunizations. Tonsils removed 2013.
Blood type: O negative
Weight: 155 lbs.
Vaginal Delivery: 35 weeks 2 days
APGARS: 1 MIN: 7, 5MIN: 9
(1 off for breathing, 2 off for color)
- Based on the chief complaint what additional assessments are needed and what do you think is going on?
- Choose 4 of the newborn skin findings below and educate the patient on what this skin finding is, what causes it and interventions needed.
- Erythema toxicum
- Mongolian spots
- Harlequin Sign
- Circumoral cyanosis
- Caput succedaneum
- Pathological jaundice
- Nevus flammeus
- Hemangiomas (stork bites/salmon patch)
- Strawberry hemangiomas
- Cold Stress in newborns:
- Explain why and how cold stress occurs.
- Describe what happens if left untreated.
- Describe the 4 methods of heat loss in infants and give an example on how to prevent each type.
- Jaundice in newborns:
- What is the pathophysiology of this disease process in newborns?
- What interventions are needed to fix this issue? How does our body conjugate the excess bilirubin?
- What places this infant at risk?
- Add a question: After you have analyzed the content from the discussion board, please add a question to the end of your initial post regarding the reading material for the week.
Please be sure to validate your opinions and ideas with citations and references in APA format.
How to Solve Please read the following case study details. Then respond to the questions below. Setting You are a nurse caring for women and children in a rural clinic. This clinic serves most of the area’s popula Nursing Assignment Help
In this case, Kristen has brought her one-week-old baby, Sawyer, to the rural clinic for a routine check-up. She has complaints of severe nipple pain and is concerned about the baby’s yellowish skin. As a medical professor, it is essential to understand the underlying issues to assist Kristen and Sawyer.
1. Based on the chief complaint what additional assessments are needed and what do you think is going on?
Kristen has complaints of nipple pain, which could be due to poor latch or thrush. A thorough breast examination is needed in such a case. The yellowish discoloration of the skin could be due to physiological jaundice, which is normal in newborn babies if it occurs after the first 24 hours of life and resolves within a few days. However, pathological jaundice needs to be ruled out, which can be done through blood tests measuring bilirubin levels and liver function.
2. Choose 4 of the newborn skin findings below and educate the patient on what this skin finding is, what causes it, and interventions needed.
a) Erythema toxicum: This is a common rash that appears in newborns with small, red spots on the skin. It is caused by the baby’s immature immune system and resolves on its own without any treatment.
b) Mongolian spots: These are blue or grayish spots that are commonly seen in darker-skinned babies. They are caused by pigment-containing cells and typically fade away by the age of 5.
c) Harlequin Sign: This is a transient change in skin color where one half of the baby’s body appears reddish while the other half appears pale. It is caused by immature blood vessels and resolves on its own without any treatment.
d) Acrocyanosis: This is a bluish discoloration seen in the hands and feet of newborns that can last for a few hours after birth. It is caused by the baby’s immature circulatory system and resolves on its own without any treatment.
3. Cold Stress in newborns:
a) Cold stress occurs when the baby’s body cannot maintain its normal temperature due to exposure to cold.
b) If left untreated, cold stress can cause respiratory distress, low blood sugar levels, and even hypothermia.
c) The four methods of heat loss in infants are radiation, conduction, evaporation, and convection. Preventing each type can be done by:
– Radiation: covering the baby’s head with a cap
– Conduction: using a warm blanket on a cold surface
– Evaporation: keeping the baby dry and avoiding too much bathing
– Convection: keeping the baby away from cold drafts or air conditioning
4. Jaundice in newborns:
a) The pathophysiology of jaundice in newborns is due to the breakdown of red blood cells, leading to the accumulation of bilirubin in the baby’s body.
b) Phototherapy is the most common treatment used to reduce bilirubin levels, and in severe cases, an exchange blood transfusion may be needed. The excess bilirubin is conjugated in the liver and excreted through the stools.
c) Infants who are born prematurely, have ABO or Rh incompatibilities with their mothers, or have a family history of jaundice are all at risk for developing jaundice.
5. What warning signs should Kristen look out for regarding her newborn’s health, and when should she bring her child back to the clinic?
As a follow-up question, I would ask Kristen to be aware of warning signs such as changes in appetite, lethargy, high-pitched crying, and difficulty breathing. If she notices any of these symptoms or is concerned about her baby’s health, she should immediately bring Sawyer back to the clinic for evaluation.