Early Onset Jaundice

Throughout my time on the Mother Baby Care Unit, I have faced many instances in which I have been able to reflect on both my patients and the care that I was providing them. One situation in particular that I found myself critically reflecting upon involved a new mother who was feeling slightly stressed about being discharged as her newborn son would not be going home with her. For confidentiality reasons, this patient will be given the pseudonym of Kayla for the remainder of this reflection.

Newborn jaundice is a condition marked by high levels of bilirubin in the blood. The increased bilirubin causes the infant's skin and whites of the eyes (sclera) to look yellow.

Risk assessment for jaundice should be performed on an infant before discharge from the hospital, using TB or transcutaneous bilirubin and/or assessment of risk factors. Therefore, if the TB is plotted on a nomogram prior to discharge, the PNP will have an idea about the infants risk for developing hyperbilirubinemia at the initial newborn visit and can guide the need for laboratory evaluation. If this is not available, the PNP should be aware of major risk factors for the development of hyperbilirubinemia including jaundice present in the first 24 hours of life, blood group incompatibility, gestational age of 35-36 weeks, sibling history of phototherapy, cephalohematoma or significant bruising, exclusive breastfeeding, and East Asian race (AAP, 2004).

For any mother the birth of a newborn child can be a challenging experience. As nurses it is part of our job to ensure their experience is positive. We can help do this by providing the information they will need to affective care for their newborn. This information includes topics such as, breastfeeding, jaundice, when to call your doctor and even how to put your baby to sleep. When the parents have an understanding of these topics before discharge it can largely reduce their natural anxiety accompanied with the transition to parenthood. Health teaching for new parents is seen as such an important aspect of care on post-partum floors it is actually a necessary component that needs to be covered before the hospital can discharge the

Another big role in a pediatric nurse’s job is telling the parents disturbing news when it is necessary. Telling the family any bad news is more of a process than anyone might think. The pediatric nurse responsible for this task must first think ahead, plan for the worse, and plan for the reaction of the family. The pediatric nurse must set time apart from their busy day to be able to spend it with the family of the patient. One is never sure how the family will react or how long it will take to explain all the details and answer all the family’s questions. , According to Crawford in his journal “It is also helpful in many cases to have a witness to what was actually said as sometimes, despite all the care and attention to detail, mixed messages can be conveyed” (Crawford 3). In the article, it also states that the pediatric nurse should give open and honest information to the family. The nurse should start the conversation off letting the family know that they are here to support and encourage. The nurse should be straight forward from there on out and should refrain from using elaborate or confusing words with the child’s family. The nurse should avoid not only confusing the family but also excuses, jargon, elaborate reasoning, and the temptation to speed through the bad news without making 100 percent positive the family understands what they are being told. When the nurse has properly told the family the bad news, he or she must

Ineffective discharge teaching often leads to unnecessary admissions to the hospital resulting in negative patient outcomes and decreased patient satisfaction. This negatively impacts the well-being of the patient and creates a financial burden on institutions. As a result, this universal practice issue requires a call to action on the part of the nursing profession. Nurses can proactively assist in assuring incidents of readmission do not occur. Nurses as educators play a critical role in the successful transition of patients from hospital to home. The overall goal of discharge education is to ensure there is an exchange of critical information between the patient and nurse in which plans of care are understood and followed. The research

Wellington serves a community that has a majority of White Non-Hispanic population. The outlying communities that utilize our services compromise a majority of Hispanic, Latino, Haitian, African American population. Currently, our staff is compromised to meet the majority of the population; we lack in the services in clientele that have recently migrated to the country or have limited understanding of the English language. We offer a language line and certain staff members that are utilized to facilitate in translation. Unfortunately, they are not always available. The author is employed as the Manager of the Neonatal intensive care unit. The unit uses a primary nursing care model and an all registered nurse staff. The group is headed by a nurse manager who reports to the Director of women's services. Currently, the unit achieves a daily census of 12; our breastfeeding rate is 90 percent, and our focus is on family-centered care.

The purpose of this paper is to display how such assessment is essential not on an individual basis, but rather on a larger scale in relation to family nursing. Family nursing “centers on the family as a unit of care, addressing family needs in response to a member’s illness or threat to health, rather than focusing on the individual. An understanding of families’ needs at particular developmental stages, how they communicate and function, and an ability to undertake a family assessment is foundational knowledge for family nursing” (St John, 2009, p.6). Often, nurses encounter the families of their individual patients on a daily basis, yet family assessments are not performed. This is because nurses often feel there is little time to engage families effectively, and in fact lack of time, has been identified by nurses as the primary barrier to engaging families (Kaakinen, 2015, p.109). Evidence based practice however, has proven that “a 15 minute, or even shorter, family interview can be purposeful, effective, informative, and even healing” (Wright, 2013, p.264). This 15 minute interview has been adopted in many acute care settings in involves five key components; manners, therapeutic conversation, key questions, commendation, and the genogram. These ideas represent the theoretical underpinning and are a condensed version of the Calgary Family Assessment Model (Wright, 2013). This model is large, but can be customized and adapted to the function of each individual

On arrival, Joe’s mother Catherine was distressed and throughout every stage of Joe’s care it was important Catherine was provided with clear information in order to empower her to make informed choices regarding Joe’s care (Glasper et al. 2010). Parental involvement was introduced after the Platt Report in 1959 which recommended that parents should be allowed to stay with their hospitalised child. The report has led to significant improvements in interactions between parents of hospitalised children and the staff who care for them (Priddis and Sheilds 2011). Sousa et al (2013) carried out a study that found communication between parents and children’s nurses is vital. Sousa et al (2013) found that almost all parents who participated in the questionnaire agreed it was a priority to get information on their child’s health condition. This indicates that is important for nurses to manage the child and family as a whole holistically (NMC 2015). Catherine

Breastfeeding more often and for longer periods of time can aid in the baby’s body process of excreting the excess bilirubin (CDC, 2015). It can also have the opposite effect on some infants. Jaundice is a more frequent occurrence in infants that are breastfed. There are two types of jaundice in breastfed infants. They are breastfeeding jaundice and breast milk jaundice.

Premature infants come into this world with lots of risks due to the fact that they are susceptible to so many different diseases. As premature births increase and the climbing number of mothers that are breastfeeding rise, the amount of infants that are developing jaundice continue to climb as well. Jaundice starts with an infant that has the inability to regulate the amount of red blood cells breaking down, other wise known as bilirubin. If the body produces too much bilirubin in the blood it is then referred to as hyperbilirubinemia. Some babies, especially newborns, do not have the ability to breakdown and excrete bilirubin properly, thus, creating a build up in their blood and surrounding tissues. As a result, bilirubin, having a natural

1. Choose one patient (new mother, newborn, or pregnant/laboring woman) and identify the priority problem. What did you contribute toward resolving or easing the problem?

On August 6, 1999 a beautiful baby girl was born, as my Father would have said. That beautiful baby girl is me, Molly Nicole Moser. However, when my brother and I came out of our Mothers womb, we were swept away. The nurses wouldn’t let my parents hold us and they rushed me to the NICU. I was then put on a ventilator within a half hour after being born. My brother Matthew, was also rushed to the NICU and was put on a vent around 11:30 that night. My family went to see my brother and me, but could only look through the window. There were bright lights shining over me because I had jaundice. Jaundice is a pretty common disease for newborns. Jaundice is a medical condition in which yellowing of the skin or whites of the eyes, arising from excess

The Health Resources and Services Administration (n.d.) recognizes home visits by a nurse improves maternal and child health. According to 2015 county data, forty percent of children living in Cabell County are from single-parent households, which signifies how beneficial this program is for our community (CHRR, 2016). Cabell County, West Virginia participates in the Maternal, Infant, and Early Childhood Home Visiting program to assist families during pregnancy through the first five years of the child’s life (HRSA, n.d.). Any expecting mother, as well as families with a child under the age of five, can participate in the program (HRSA,

As the percentage of vaginal births with stays under 2 days doubled between 1990 and 1995 (figure 1), there was evidence of increasing hospital re-admission rates for neonatal jaundice resulting from early discharges (Maisels and Kring, 1998). The California Newborns’ and Mothers’ Health Act of 1997 (NMHA), which went into effect on 26 August 1997, mandated insurance coverage of a minimum of 48-hours for hospital births (Evans, Garthwaite and Wei, 2008).