NCP The Neonate at 24 to 48 Hours Following Early Discharge

This plan of care focuses on the infant who is discharged within 30 hr of birth. It is intended to be used in conjunction with the CP: The Neonate at Two Hours to Two Days of Age. Although early discharge may be detrimental to a few infants, newborn health appears to hinge more on the parent(s) level of knowledge and support at home. The home assessment at 24–48 hr following discharge involves evaluation of the newborn’s ability to adapt positively to extrauterine life.

NEONATAL ASSESSMENT DATA BASE

To meet the stringent criteria for early discharge, the newborn must be a normal, healthy infant as determined by thorough physical examination: Gestational age, 38–42 wk; birth weight, 2500–4000 g; vital signs and temperature stable; Apgar score greater than 7 at 1 and 5 min; normal elimination pattern; and successful feeding.

DIAGNOSTIC STUDIES

Hct: 40%–61%
Coombs’ Test: Negative
Screening tests, including PKU and thyroid tests, dependent on individual risk factors and agency policy

NURSING PRIORITIES

1. Support transition of newborn to extrauterine life.
2. Promote positive parent-infant interaction.
3. Provide support and information regarding home care of infant.