Nursing Care Plan for Neonatal Hypoglycemia

Neonatal hypoglycemia

Neonatal hypoglycemia is low blood sugar (glucose) in the first few days after birth.

Symptoms of Neonatal Hypoglycemia

Infants with hypoglycemia may not have symptoms. If they do occur, symptoms may include:

• Bluish-colored skin (cyanosis)
• Breathing problems
• Decreased muscle tone (hypotonia)
• Grunting
• Irritability
• Listlessness
• Nausea, vomiting
• Pale skin
• Pauses in breathing (apnea)
• Poor feeding
• Rapid breathing
• Problems with maintaining body heat
• Shakiness
• Sweating
• Tremors
• Seizures

Treatment of Neonatal Hypoglycemia

Infants with hypoglycemia may need to receive:

Feeding with breast milk or formula within the first few hours after birth, either by mouth or through a tube inserted through the nose into the stomach (nasogastric lavage)
A sugar solution through a vein (intravenously) if the baby is unable to feed by mouth, or if the blood sugar is very low

Treatment normally continues for a few hours or days to a week.

If the low blood sugar continues, the baby may also receive medication to increase blood glucose levels (diazoxide) or to reduce insulin production (ocreotide).

In rare cases, newborns with very severe hypoglycemia who don’t improve with treatment may need surgery to remove part of the pancreas (to reduce insulin production).

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Hyperthermia Care Plan for Nurses

Hyperthermia


DEFINITIONS:

Circumstances where an individual experiencing an increase in body temperature above peroral C 37.80 / 38.80 C per-rectal due to external factors (Carpenito, 1995)

PURPOSE:

Addressing the problem of increase in body temperature to prevent the lack of fluids or other complications due to hyperthermia.

CRITERIA:

Temperature 36 to 37.5 C, no complaints of fever, chills no, elastic skin turgor, vital signs within normal range (blood pressure, pulse, CVP and JVP)


NURSING DIAGNOSIS :

• Deficient fluid volume
• Altered Body Temperature
• Hyperthermia

NURSING ACTION - Care Plan for Hyperthermia:

• Monitor body temperature
• Monitor blood pressure, respiratory frequency, and pulse
• Monitor intake and output every 8 hours
• Encourage much to drink when there is no contraindication
• Maintain adequate ventilation in the room
• Give a warm compress
• Use clothing that is thin and absorbs perspiration
• Encourage clients to total bedrest
• Monitor client's hydration status

HEALTH EDUCATION:

• Teach how to properly compress
• Explain the importance of fluid to maintain normal body temperature

Act of collaboration:

• Maintain intravenous fluids according to program
• Give antipyretics according to program
• Give therapy, for the cause of fever according to program

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Ineffective Breathing Pattern Care Plan

Ineffective breathing pattern

DEFINITIONS:

Inspiration and / or expiration that does not provide adequate ventilation

PURPOSE:

Addressing the problem of ineffective breathing pattern

CRITERIA:

• There was no increased work of breathing
• There is no use of accessory muscles / retractions and asymmetrical chest expansion
• No dyspnoea and cyanosis
• Blood Gas Analysis within normal limits
• Vital signs within normal limits
• No additional breath sounds

NURSING DIAGNOSIS INEFFECTIVE BREATHING PATTERN CARE PLAN :

Ineffective breathing pattern related to

• Fatigue, changes in the ratio of O2 and CO2
• Anxiety, hyperventilation, hypoventilation syndrome
• Pain
• Bone deformities, spinal cord injury
• Neuromuscular dysfunction
• Obesity

NURSING INTERVENTIONS INEFFECTIVE BREATHING PATTERN CARE PLAN

• Review the causes of respiratory failure
• Observations of breathing patterns
• Auscultation of lung sounds periodically, note the quality of breath sounds, wheezing, expiratory lengthening and observation symmetry chest movement
• Determine the location and extent of crackles in the sternum
• Ensure breathing in tune with vgentilator and no resistance (Fighting)
• Attach and fill the balloon with the proper ETT fixation
• Have resuscitation equipment close to the client, perform manual ventilation if necessary

HEALTH EDUCATION:

• Teach the client and family relaxation techniques to increase effective breathing pattern
• Teach how to cough effectively
• Talk about home-care plan

Act of collaboration:

• Ventilator settings and adjust the ventilator pattern with the client's condition
• Observation konsintrasi O2 (Fi O2) is given
• Encourage deep breath through the abdomen during the period of respiratory distress
• Record the pressure and the airway pressure waveform monitor
• Ensure humidity and air temperature of inspiration and periodically checks
• Set and check the ventilator alarm

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