A baby girl was born at 38 weeks’ gestation, birth weight 26
A baby girl was born at 38 weeks’ gestation, birth weight 2625 gm… A baby girl was born at 38 weeks’ gestation, birth weight 2625 gm to a gravida 2 para 2, 34-year-old mother. The pregnancy was described as “uneventful”. The birth was by spontaneous vaginal delivery and was “uncomplicated”. Breastfeeding wasinitiated “with some difficulty” and required “considerable assistance” from the lactation nurseconsultant. Despite problems with nursing, the baby and mother were discharged after two days in hospital.The discharge weight was 2355 gm – a weight loss of 270 gm from birth. The mother was givenstrict instructions to nurse at least every 3 hours, and an early post discharge follow-upappointment was made for seven days after discharge. However, no homecare nurse follow-upwas arranged. Approximately two to three days after discharge, the baby developed a purulent eye dischargeand was taken into the family physician on about day seven. Antibiotic eye drops wereprescribed, and the mother was told to make an appointment if the situation worsened or didnot improve. The baby began sneezing and coughing, had an increasing reluctance to breastfeed and becamequite irritable. On day 14 of life, the baby was brought in for a routine follow-up at the request of the familyphysician. The baby weighed 1845 gm at that time and appeared wasted. The baby was immediately transferred to the local community hospital’s pediatric department. On admission to the hospital: Lethargic Temp: 98.6 axillary, RR: 48 and shallow respirations. HR: 180-200, Blood pressure wasattempted but could not be obtained. Responsive to stimulation with a weak moan. Oxygen saturation monitoring was attempted but, with poor perfusion (capillary refill: 4 sec),was difficult to achieve. Supplementary oxygen was, therefore, prophylactically administered, and the baby placedunder a radiant warmer. s:4. What laboratory and diagnostic orders do you anticipate?5. As you continue with your assessment, you want to gather more information. Whats will you ask the infant’s caregiver? List in order of priority.6. This is your patient. What abnormalities do you note?Health Science Science Nursing NUR 1213
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