Chapter 23: Home Care of the Infant Flashcards
1
Q
needs of new parents
A
- Sleep
- Anxiety of new roles
- Concern about ongoing care of infant and adjustment to parenthood
2
Q
sources of information for new parents
A
- in hospital, parents often receive more info than they can absorb
- new mothers’ physical needs and anxiety often interfere with learning shortly after birth
- so parents may be inadequately prepared to deal with early parenting
- new mothers’ physical needs and anxiety often interfere with learning shortly after birth
- extended family may not be available for support
- Parents now rely on friends, HCP, child care classes, TV, Books, magazines, and the internet rather than on family as it used to be
- Parents should determine if the information is valid
- Nurses are the ideal source
3
Q
home visits
A
- ideally scheduled during first 24-72 hours after discharge
- visits are usually 60-90 minutes
- allows for early assessment and intervention for problems with nutrition, jaundice, newborn adaptation, and mother infant interaction
4
Q
visits to low risk families
A
- nurse performs physical exam of mom and baby
- family adaptation and mother’s support system are assessed
- reinforcement of teaching from birth facility is done
- safety in the home is discussed
- especially valuable at assessing for jaundice
- nurse can check TC bili level and draw blood
- feeding is often discussed
5
Q
visits to high risk families
A
- parents may be anxious about caring for an infant who had prolonged hospitalization
- nurse may come to the home before infant’s discharge to help them accommodate equipment and care infant needs
- nursing visits can help family maintain infant’s health and decrease the need for rehospitalization
- infants with complications often have common problems like respiratory illness, infections (sepsis, UTIs, otitis media), and need for surgery, so nurses can help parents get info on preventive measures and care of infants with acute illness
6
Q
outpatient visits
A
- provided in a pediatrician’s office
- feeding session is often observed for the lactating mother to provide assistance
- advantage: nurse doesn’t have to travel and can see more patients each day, therefore it is cheaper
- visits last 30-45 min
7
Q
telephone counseling
A
- may provided during follow up calls to discharged patients
- much less expensive
- disadvantage is nurse cannot perform an in person assessment of mother, baby
8
Q
follow up calls
A
- placed by the nurse in the first few days after discharge
- nurse asks series of questions to assess physical condition of mother/infant and to identify any needs or problems
9
Q
warm lines
A
- also called help lines or information lines
- provide parents with an opportunity to ask a nurse questions arising from daily challenges of parenting
- used for troubling, but not emergency, situations
- should be available 24 hours a day
- parents often call about: infant feeding, breastfeeding concerns, postpartum blues, and basic care of mother and infant
10
Q
telephone techniques
A
- open ended questions should be used
- telephone triage involves determining the existence of and solution to a serious problem
- nurse must be skilled at soliciting information to identify problems and determine if those problems indicate the family should come in or if they can wait
- the nurse should help the caller describe major concerns
11
Q
red flags of telephone triage
A
- an emergency situation: tell parents to call 911, and call back in 5 min to make sure they sought help
- illness (fever, dehydration, change in feeding, rashes)
- severe feeding problems (infant may become dehydrated or jaundiced)
- problem has been present for longer than usual (prolonged crying or sleeping)
- parent’s affect seems inappropriate for situation
12
Q
safety considerations of infant equipment
A
- few pieces of equipment are absolutely essential to newborns
- safety is most important consideration
- new equipment sold in the US follows governmental standards
- hand me down equipment should be checked to be sure it has not been recalled
13
Q
car safety seats
A
- essential to reduce injury and death
- laws require restraint of infants and young children
- rear facing seats should be used until 2 years of age or have reached highest weight/height allowed by manufacturer
- seat should recline at approx 45deg
- blankets should never be placed under the infant
- safest when in the center, back seat of the car
- safety harness should be at the level of their axilla across their chest
14
Q
early problem: crying
A
- peaks at about 6 weeks at up to 3 hours/day
- usually dec to 1 hour or less each day by 3 mos
- cry for many reasons including hunger, discomfort, fatigue, overstimulation, boredom
- crying is how an infant signals unmet needs
- infants cannot be spoiled when infants respond to those needs
- needs must be met in a consistent, warm, and prompt manner for development of trust to occur
15
Q
what is colic?
A
- characterized by irritable crying for no obvious reason for 3 hours or more per day
- usually takes place during the late afternoon or evening on at least 3 days/week, lasting at least 3 weeks
- begins at 2-3 weeks, peaks at 6-8 weeks, and ends at 3-4 mos
- happens in both breast and formula fed babies
- they cry as though they are in pain, draw knees onto abdomen or rigidly extend legs, and may pass flatus
16
Q
colic: interventions
A
- nursing interventions:
- therapeutic communication to help parents express frustrations
- explain it is not abnormal to feel angry and it is essential to take time away from the infant
- helps to feed infant in upright position and burp frequently
- chamomile tea
- 5 S’s: swaddling the infant in the side or stomach position, making shushing sounds while swinging the baby, and haing baby suck on pacifier
- quiet environment, calm approach, regular schedule
