Introduction
Weight loss may occur in newborns within the first week of their lives to up to 10%, probably because the baby is not getting enough milk, the mother not producing enough milk, or as a result of a medical condition (Betz, 2018).
Etiology/Pathophysiology
Newborn babies being breastfed can lose weight due to a variety of reasons that include; the baby was not breastfeeding enough, the baby’s inability to latch correctly, incorrect breastfeeding latch, sleepiness, and incorrect use of a nipple shield. Factors related to the mother’s milk production, such as true low milk supply, caused hypothyroidism, hypoplastic breasts, previous breast surgery, and late-onset milk production due to stress or retained placenta, may also cause the child’s weight loss (Betz, 2018).
Common Symptoms
The most reliable way of identifying the baby’s weight loss is by conducting regular check-ups and weigh-ins. The baby is observed to have lost more than 10% of his/her birth weight. Other signs may include the baby appearing ill and having flu-like symptoms (Betz, 2018).
Potential Complication
The possible short-term complication of continued weight loss may include increased infection rates, respiratory, digestive, or nervous problems, persistent ductus arteriosus, and sudden infant death syndrome. Long-term complications may involve developmental delay, cerebral palsy, deafness, and blindness.
Expected Findings
The significant abnormal finding obtained from the assessment of breastfeeding newborns with weight loss is the loss in body weight. The skin may be wrinkled; however, other assessment findings should be normal.
Diagnostic Studies
A laboratory test that should be performed involves a thyroid function test to assess thyroid hormones that guide metabolism. Phenylketonuria test, galactosemia, and sickling test. Stool examination may also be done to assess the digestive function of the GIT (Betz, 2018).
All NANDA Nursing Diagnoses
- Investigation of eating disorders related to low sucking and swallowing reflexes.
- Investigating the duration and breastfeeding pattern of the newborn baby.
- Investigation of mother’s knowledge, attitude, and breastfeeding behavior.
- Evaluating the baby’s latch during breastfeeding.
- Evaluation of mother’s quantity of milk production and possible causes of low quantities.
3 NANDA Priority Nursing Diagnosis
- Assessment of breastfeeding pattern and behavior.
- Problems with baby’s ability to latch correctly during breastfeeding.
- Investigation of eating disorders related to low sucking and swallowing reflexes.
Patient Goals
The patient goal to ensure that there is an improvement in the patient weight, growth, and development.
Evaluation
The care plan can be evaluated by constantly checking the weight of the child for improvement.
Medication
No medication is needed in this care plan.
Definition of Medical Diagnosis: HIV Infection Causing AIDS
Etiology/Pathophysiology
Infection by HIV causes damage to the immune system by attacking the immune cells called the CD+ cells. Before destroying the CD4+ cells, the virus utilizes the cells’ DNA to replicate. Destruction of the immune system means increased susceptibility to infection by bacteria and other viruses (Ricci et al., 2012).
Common Signs and Symptoms
The common signs and symptoms of HIV infection include chills, rash, night sweats, muscle aches, sore throat, swollen lymph nodes, fatigue, diarrhea, and mouth ulcers. The symptoms, however, depend on the stage of infection.
Potential Complication
Potential complications may include primary central nervous system lymphoma, chronic psychiatric disorders, endocarditis, and cardiovascular diseases, chronic obstructive pulmonary disease, Kaposi sarcoma, and other HIV-related malignancies (Silvestri, 2017).
Assessment and Expected Findings
Assessment of gait and posture possible normal. General skin condition (skin is expected to have a rash). Vision and hearing possibly normal. Abnormal lung sounds may be observed in case of lung infection (Silvestri, 2017). Blue discoloration of the skin and mucous membrane caused cyanosis. Change in shape of nails. They have swollen lymph nodes, swollen thyroid glands. Conjunctivitis may be observed in the eye. Possible purulent discharge from nose, ear, mouth, and throat. Chest murmurs and raised JVP. Tender abdomen and masses due to hepatomegaly and splenomegaly (Silvestri, 2017).
Diagnostic Studies
CD4+ count low below 200; Screening for infections: CrAg; HepBsAg; RPR or TPHA / FTA / rapid TP (TP specific tests). Abnormal levels of hemoglobin and WBC differentials. High viral load. Altered fasting lipid profile. TB test is possibly positive (Ricci et al., 2012).
All NANDA Nursing Diagnosis
- Imbalanced nutrition; less than body requirements.
- Patient’s ability to maintain personal hygiene, i.e., cleaning food and domestic utensils.
- The diagnoses of anxiety, low situational self-esteem, and fear were identified in few patients.
- Self-care and drug use alongside patient’s knowledge of the condition and medication use.
Three Priority NANDA Nursing Diagnosis
- Patient self-care and use of medication, patient nutrition, and patient psychiatric condition.
- Patient goals
- Relieve patient from infection, proper medication to boost immunity, and improve nutrition.
Evaluation of Care Plan
Measuring the patient viral load and CD4+ count as well as checking the patient’s anthropometric measurements.
Medications
Appropriate antibiotics and ARVs. Side effects may include allergic reactions, heart diseases, and bone loss, among others.
References
Betz, C. (2018). Promoting excellence in pediatric nursing practice and science.Journal of Pediatric Nursing, 38, i-iii. Web.
Ricci, S., Kyle, T., & Carman, S. (2012). Maternity and pediatric nursing (2nd ed.). Lippincott Williams & Wilkins.
Silvestri, L. (2017). Saunders comprehensive review for the NCLEX-RN® Examination. Elsevier.