The client is a large for gestational age (LGA) baby boy born at 37 weeks gestation via vaginal delivery. He had normal Apgar scores of 8 and 9. The mother is breastfeeding. As the discharging nurse, you must complete a full assessment of the baby, required newborn screenings, provide discharge instructions to the mother, and document the encounter. This will include assessing gestational age using the Ballard score, ensuring the baby has received the hepatitis B and vitamin K vaccines, and instructing the mother on proper breastfeeding, umbilical cord care, signs of illness to watch for, and making a follow up appointment.
The client is a large for gestational age (LGA) baby boy born at 37 weeks gestation via vaginal delivery. He had normal Apgar scores of 8 and 9. The mother is breastfeeding. As the discharging nurse, you must complete a full assessment of the baby, required newborn screenings, provide discharge instructions to the mother, and document the encounter. This will include assessing gestational age using the Ballard score, ensuring the baby has received the hepatitis B and vitamin K vaccines, and instructing the mother on proper breastfeeding, umbilical cord care, signs of illness to watch for, and making a follow up appointment.
The client is a large for gestational age (LGA) baby boy born at 37 weeks gestation via vaginal delivery. He had normal Apgar scores of 8 and 9. The mother is breastfeeding. As the discharging nurse, you must complete a full assessment of the baby, required newborn screenings, provide discharge instructions to the mother, and document the encounter. This will include assessing gestational age using the Ballard score, ensuring the baby has received the hepatitis B and vitamin K vaccines, and instructing the mother on proper breastfeeding, umbilical cord care, signs of illness to watch for, and making a follow up appointment.
The client is a large for gestational age (LGA) baby boy born at 37 weeks gestation via vaginal delivery. He had normal Apgar scores of 8 and 9. The mother is breastfeeding. As the discharging nurse, you must complete a full assessment of the baby, required newborn screenings, provide discharge instructions to the mother, and document the encounter. This will include assessing gestational age using the Ballard score, ensuring the baby has received the hepatitis B and vitamin K vaccines, and instructing the mother on proper breastfeeding, umbilical cord care, signs of illness to watch for, and making a follow up appointment.
As a postpartum nurse your next client is an LGA baby boy who was born at 37
weeks' gestation. He had Apgar scores of 8 and 9. The mother is breast-feeding. Your unit requires a full assessment, screenings, discharge instructions, and documentation. A. Describe and demonstrate what a normal head-to-toe assessment would be for an infant born at 37 weeks' gestation. What test is used to determine this gestational age? What is the scale used to determine the Apgar score, and are this baby’s scores normal? B. As the discharging nurse, you are responsible for what screenings in an infant in the first 24 to 48 hours? What immunizations would be required?
• Based on the scenario the baby is LGA means that Infants who are born large for gestational age (LGA), especially full-term or post-term infants, are at risk for perinatal morbidity and potentially long-term metabolic complications. The most common problems of LGA infants (hypoglycemia, birth injuries, and lung problems) typically resolve over a few days with no long-term consequences. As adults, LGA girls have an increased risk of having an LGA infant. All LGA infants are at risk of obesity and may have an increased risk of heart disease.
• We used The Ballard score, is commonly used to determine gestational age.
Examination evaluates a baby's appearance, skin texture, motor function, and reflexes. The physical maturity part of the examination is done in the first 2 hours of birth. The neuromuscular maturity examination is completed within 24 hours after delivery.
For the Discharge instructions this includes
Properly feeding the infant
• Instruction on proper breastfeeding position, attachment, and adequacy of swallowing • Breastfeeding mothers should consult their physicians before taking any new medications. • Parents should not give their infant supplemental water or honey. • Breastfed and bottle-fed infants receiving less than 500 mL of formula per day should receive 200 IU of a vitamin D supplement per day. Urination patterns
• Six or more wet diapers per day is normal for a breastfed infant after the mother’s milk has come in, as well as for bottle-fed infants. • Bowel movements • More than three bowel movements per day is normal in breastfed infants. • Bottle-fed infants may have fewer bowel movements. Umbilical cord care
• Instruction on proper cleaning
• Skin care • Review of common rashes • Genital care • Instruction on proper care of circumcised oruncircumcised penises, as well as care of newborn girls’ genitals Signs of illness
• Rectal temperature of 100.5˚F (38˚C) or higher
• Signs of dehydration, lethargy, poor feeding • Prevention of sudden infant death syndrome • Instruction on properly positioning the infant for sleep • Parental smoking cessation • Car seat selection and proper use Follow-up appointment made at discharge
• Infants younger than 24 hours, follow up within 72 hours of age
• Infants 24 to 48 hours of age, follow up within 96 hours of age • Infants older than 48 hours, follow up within 120 hours of age On the video that I submitted I include the APGAR SCORE, BALLARD SCORE AND ANTHROPOMETRIC MEASUREMENT, VITAMIN K ADMINISTRATION AND HEPATITIS B VACCINATION
