The birth of a child with special needs, regardless of whether the condition is temporary or permanent, creates unique concerns for the family, who mourns the loss of a normal, healthy child. Conditions range from prematurity, growth deviations, and infections to gross anomalies. Although each case is individual and varies in degree of involvement, many similarities are observed in the parents’ responses to their child.
(This plan of care is to be used in conjunction with the routine postpartal plans of care.)
CLIENT ASSESSMENT DATA BASE
(Refer to Client Assessment Data Base in CPs: the Client at 4 Hours to 2 Days Postpartum; Care Following Ceasarean Birth (4 Hours to 3 Days Postpartum); The Client at 24 Hours Following Early Discharge; The Client at 1 Week Following Discharge; and The Client at 4 to 6 Weeks Following Delivery.)
Ego Integrity
Varied emotional responses (e.g., calm, withdrawal, irritability, restlessness, weeping, anger)
History of postpartal depression or psychosis
Safety
History of exposure to teratogenic factors
Presence of infectious agents (including HIV), premature rupture of membranes
Sexuality
Unexpected intrapartal event (e.g., dysfunctional labor, hemorrhage)
History of birth of a child with special needs and/or perinatal loss
Teaching/Learning
History of substance use/abuse
DIAGNOSTIC STUDIES
Genetic Studies/Chromosomal Analysis: Helps determine presence of syndromes/inherited disorders, general prognosis, and future expectations.
Other Testing: Dependent on specific findings and individual risk factors.
NURSING PRIORITIES
1. Facilitate grieving and positive coping.
2. Provide appropriate information related to short- and long-term implications of child’s illness or anomaly.
3. Facilitate learning of parenting role and participation in infant care tasks.
DISCHARGE CRITERIA
1. Demonstrate progress in dealing with grief at own pace.
2. Display appropriate attachment/bonding behaviors.
3. Participate in infant care; develop mastery of therapeutic regimen.
4. Have plan in place to meet needs after discharge.
(This plan of care is to be used in conjunction with the routine postpartal plans of care.)
CLIENT ASSESSMENT DATA BASE
(Refer to Client Assessment Data Base in CPs: the Client at 4 Hours to 2 Days Postpartum; Care Following Ceasarean Birth (4 Hours to 3 Days Postpartum); The Client at 24 Hours Following Early Discharge; The Client at 1 Week Following Discharge; and The Client at 4 to 6 Weeks Following Delivery.)
Ego Integrity
Varied emotional responses (e.g., calm, withdrawal, irritability, restlessness, weeping, anger)
History of postpartal depression or psychosis
Safety
History of exposure to teratogenic factors
Presence of infectious agents (including HIV), premature rupture of membranes
Sexuality
Unexpected intrapartal event (e.g., dysfunctional labor, hemorrhage)
History of birth of a child with special needs and/or perinatal loss
Teaching/Learning
History of substance use/abuse
DIAGNOSTIC STUDIES
Genetic Studies/Chromosomal Analysis: Helps determine presence of syndromes/inherited disorders, general prognosis, and future expectations.
Other Testing: Dependent on specific findings and individual risk factors.
NURSING PRIORITIES
1. Facilitate grieving and positive coping.
2. Provide appropriate information related to short- and long-term implications of child’s illness or anomaly.
3. Facilitate learning of parenting role and participation in infant care tasks.
DISCHARGE CRITERIA
1. Demonstrate progress in dealing with grief at own pace.
2. Display appropriate attachment/bonding behaviors.
3. Participate in infant care; develop mastery of therapeutic regimen.
4. Have plan in place to meet needs after discharge.
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