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discussion
Discussions A/B
Complete the discussion in Group A or B as assigned by the
instructor and then respond to the alternate group. All students are required
to review all posts for general knowledge. Keep in mind that you will earn
points for your initial discussion posts, as well as your responses. If you do
not posts responses, you cannot earn full credit. Refer to the Discussion
Rubric on how points are earned.
DISCUSSION A
Group A will complete the initial post. Group B will
respond. You are called to the room and find Michael 2 hours old has been very
irritable and spitting up large amounts of formula. He is very jittery. You do
not know the maternal history before coming into the room so you advise the
mother that you would like to return the baby to the nursery for an assessment
and monitoring. In the medical record you focus on prenatal history. You
witness the baby having some significant tremors. What would you suspect?
Michaels VS are: T (axillary) – 36.0, RR- 70, HR- 166, he is very alert,
irritable, and does not console easily. Is moving constantly, and sucking very
vigorous on the pacifier you provide for comfort. You place the baby under the
warmer and obtain what labs?
It is determined that this baby is going through opioid
withdrawal. Neonatal Abstinence Syndrome requires close observation and
scoring. Methadone may be used. Neonatal Abstinence Syndrome Shows both the
signs of withdrawal, scoring and the nursing care of a baby with Neonatal
Abstinence Syndrome.
Group B Response
What is your feeling and knowledge regarding breastfeeding
this baby?
DISCUSSION B
Group B will complete the initial post. Group A will
respond. Baby Leah had a very traumatic vaginal birth. After a vacuum
extraction for fetal heart rate tracing changes and a resultant shoulder
dystocia, Leah has a mild Erb’s palsy, some facial and truncal bruising.
Pediatrician has ordered physical therapy for the palsy and the doctor expects
routine care to be provided to her. In addition, do not forget the education
you must give to the new parents regarding this injury. Due to the bruising
there is an increase in bilirubin levels and some behavioral changes occur with
Leah. Please describe what is different and what will you discuss with the
family to ensure safety? The bilirubin level requires phototherapy. What
precautions must you take? What is essential to manage and treat the elevated
bilirubin in addition to phototherapy?
Group A Response Phototherapy is discontinued at the
hospital, but at home the parents are encouraged to provide some ‘routine’
therapy for Hyperbilirubinemia. What would you suggest? Do not forget routine
discharge instruction for this parent.
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