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Health, Medicine, Nursing
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Case Study
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English (U.S.)
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Newborn Case Study Progress Research Paper: Maternity

Case Study Instructions:

 

NEWBORN CASE STUDY


Baby H. was just born in a hospital that provides single-room maternity care (VHC). VHC allows the infant to remain with the parents after birth. The nurse will complete the physical assessment and observe for physiologic changes in the infant’s transition from intrauterine to extrauterine life. The textbooks will tell you that the infant goes through an initial phase of reactivity 30 to 60 minutes after birth, then a sleep phase for 4 to 6 hours, then a second period of reactivity. You will see variations of the timing in actual practice.
1. What care is specific to the first period of reactivity?
2. The sleep phase and second reactive phase might occur in the VHC or in the nursery. Identify eight assessments or tasks that the nurse needs to do during the transitional care period.
3. You are preparing to give the injection of vitamin K (AquaMEPHYTON). The order is to give 0.5 mg subcutaneously upon arrival to the nursery. The medication comes in a solution of 1 mg/0.5 mL. Calculate how much medication you will draw up into the syringe.
4. Once the transitional care and documentation are completed, what ongoing care of the newborn is the nurse responsible for?
5. The laboratory also performs a Coombs’ test on Baby H. What is the purpose of the Coombs test?
a. it is done to identify the infant’s blood type
b. it tests for damage to the red blood cells from maternal antibodies
c. it checks the red blood cell for anemia.
6. True or False: A phenylketonuria (PKU) blood test can be done any time before an infant is discharged home. If false, explain your rationale.
 

CASE STUDY PROGRESS


Baby H’s mother has decided to breast feed her infant. She asks for assistance.
7. Identify six important points to include in your teaching plan.
8. Baby H.'s mother calls you to tell you that her baby seems too sleepy and not feeding well. What will your next action be?

Case Study Progress


You are meeting with Baby H.'s mother to review discharge instructions. She has many questions.
9. Baby H.'s mother asks you about cord care and circumcision care for her infant. What will you tell her?
10. Baby H.'s mother asks you how she can keep her infant from catching a cold or some other type of infection. What is the most important measure to teach her?
11. After discharge, it is important for Baby H. to receive follow-up care. What should you teach the mother to help her understand the importance of regular visits?
12. You realize that Baby H.'s mother needs information about safety issues before being discharged. After reviewing safety issues, which statement by Baby H.'s mother indicates that she needs further instruction?
I have a car seat and will use it for my baby every time we use the car.”
I can leave him on the infant table for just a few moments while he is a newborn.”
I will not drink hot coffee while holding my baby.”
I will check the bath water temperature before bathing him.”
Perry (2014). Maternal Child Nursing Care (5th ed.). Philadelphia, PA: Elsevier. "can you please add this book as part of the references plus the additional 2 you will choose"
follow the grading Rubric for the Case study. I need the listed answers numbers from Question 1 to 12, please don’t include the question on the paper. ONLY THE ANSWERS
e.g. (1. Then the answer to the question).
Criterion  

CASE STUDY RUBRIC TO FOLLOW


Identification of Main Issues/Problems = Identifies and demonstrates a sophisticated understanding of the main issues/problems in the case study.
Analysis and Evaluation of Issues/Problems = Presents an insightful and thorough analysis of all identified issues/problems; includes all necessary calculations. 
Recommendations on Effective Solutions/Strategies = Supports diagnosis and opinions with strong arguments and well- documented evidence; presents a balanced and critical view; interpretation is both reasonable and objective. 
Links to Course Readings and Additional Research = Makes appropriate and powerful connections between identified issues/ problems and the strategic concepts studied in the course readings and lectures; supplements case study with relevant and thoughtful research and documents all sources of information. 
Writing Mechanics and Formatting Guidelines = Demonstrates clarity, conciseness and correctness; formatting is appropriate and writing is free of grammar and spelling errors. Uses APA and citations appropriately; uses 2 or more references.

Case Study Sample Content Preview:
Case study: Maternity
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Case study: Maternity
The care specific to the 1st reactivity period is breastfeeding. If the infant is adapting properly to life outside of the mother’s womb, the mother should breastfeed the baby. It is important for the baby to get colostrums from the mother. If the baby does not breastfeed in the initial six hours following birth, he may become dehydrated (Perry, 2014).
The 8 assessments/tasks which the nurse must do in the transitional care period are as follows:
General measurements such as weight, length, chest and head circumference;
Gestational age assessment. For maximum reliability, gestational age needs to be assessed in the initial four hours of birth.
General appearance assessment. Findings that might be seen include jaundice, lack of interest in the environment, cyanosis, heart rate over 160 bits per minute or less than 100 bits per minute, lack of responsiveness or movement, and hypertonic or hypotonic position (Pillitteri, 2013).
Skin assessment. Some warning signs include long nails, meconium staining, poor skin turgor, pallor, extra skin folds, bullae, and thin translucent skin.
Head assessment including shape and size of the head and cranial structure.
Eye, ear, nose, mouth and neck assessment
Assessment of the respiratory and cardiovascular system
Neurological assessment
Genitourinary system assessment
Extremities, spine and back assessment
The medication that would be drawn up into the syringe is 0.5 to 1 mg.
The ongoing care of the baby which the nursing personnel has the responsibility for after the completion of the transitional care and documentation is to provide some teaching to the mother about hunger cues as well as other ways which the baby might communicate his needs.
The purpose of the Coombs test is c. It checks the red blood cells for anemia.
False. This is because a phenylketonuria (PKU) blood test is only done after a day or 2 days following the birth of the infant. This test is not performed before the infant is twenty-four hours old or before the infant has ingested some protein in the diet in order to make sure that accurate and precise results are obtained (Dickason, Schultz & Silverman, 2014).
The 6 vital points to include in the teaching plan include the following:
Positioning the baby. Some of the breastfeeding holds include side-lying, cross-cradle, football, and cradle.
Begin with the breast which the preceding breastfeeding ended with
Latch on – position the infant at breast level. The mouth of the baby should be wide and facing the breast (United States Department of Health and Human Sciences, 2016).
Breastfeed on demand but awaken at least every three ...
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