Nursing Care Plan Ineffective Relationship Definition;Impaired ability of an infant to suck or coordinate the suck/swallow response resulting in inadequate oral nutrition for metabolic needs,Nursing Care Plan.

Defining Characteristics

• Inability to coordinate sucking, swallowing, and breathing
• Inability to initiate or sustain effective suck

Related Factors

• Anatomic abnormality
• Oral hypersensitivity
• Neurological delay or impair
• Prematurity ment
• Prolonged NPO status

Assessment Focus

• Fluid and electrolytes
• Nutrition
• Growth and development
• Roles/relationships

Expected Outcomes

The Neonate Will

• Not lose more than 10% of birth weight within first week of life.
• Gain 4–7 oz (113.5–198.5 g) after first week of life.
• Remain hydrated.
• Receive adequate supplemental nutrition until able to suckle suffi-ciently.
• Establish effective suck-and-swallow reflexes that allow for adequate intake of nutrients.

The Parents Will

• Identify factors that interfere with neonate establishing effective feeding pattern.

• Express increased confidence in their ability to perform appropri-ate feeding techniques.

Suggested Noc Outcomes

Breast-Feeding Establishment: Infant; Breast-Feeding Maintenance;Muscle Function; Nutritional Status: Food & Fluid Intake;Swallowing Status

Interventions And Rationales

Determine: Weigh neonate at the same time each day on the same scale to detect excessive weight loss early.Continuously assess neonate’s sucking pattern to monitor for inef fective patterns.Assess parents’ knowledge of feeding techniques to help identify and clear up misconceptions.Assess parents’ level of anxiety about the neonate’s feeding diffi-culty. Anxiety may interfere with the parents’ ability to learn new techniques.201 Monitor neonate for poor skin turgor, dry mucous membranes,decreased or concentrated urine, and sunken fontanels and eyeballs to detect possible dehydration and allow for immediate intervention.Record the number of stools and amount of urine voided each shift. An altered bowel elimination pattern may indicate decrease food intake; decreased amounts of concentrated urine may indicat dehydration.Assess the need for gavage feeding. The neonate may temporarily require alternative means of obtaining adequate fluids and calories.If neonate requires intravenous nourishment, assess the insertion site, amount infused, and infusion rate every hour to monitor fluid intake and identify possible complications, such as infiltration and phlebitis.Perform: Remain with the parents and neonate during the feeding to identify problem areas and direct interventions.For bottle-feeding, record the amount ingested at each feeding; for breast-feeding, record the number of minutes the neonate nurses a each breast and the amount of any supplement ingested to monitor for inadequate caloric and fluid intake.Provide an alternative nipple, such as a preemie nipple. A preemie nipple has a larger hole and softer texture, which makes it easier for the neonate to obtain formula.For breast-feeding, ensure that the neonate’s tongue is properly positioned under the mother’s nipple to promote adequate sucking.Alternate oral and gavage feeding to conserve the neonate’s energy.Inform: Teach parents to place the neonate in the upright position during feeding to prevent aspiration.Teach parents to unwrap and position a sleepy neonate before feeding to ensure that the neonate is awake and alert enough to suckle sufficiently.Attend: Provide positive reinforcement for the parents’ efforts to improve their feeding technique to decrease anxiety and enhance feelings of success.Manage: Assess neonate for neurologic deficits or other pathophysio-logic causes of ineffective sucking to identify the need for referral for more extensive evaluation.

Suggested Nic Interventions

Attachment Promotion; Breast-Feeding Assistance; Lactation Coun-seling; Nonnutritive Sucking

Reference

Kelly, M. M. (2006, September–October). Primary care issues for the healthy premature infant. Journal of Pediatric Health Care, 20(5), 293–299.

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Nursing-CarePlans.com, Nursing Care Plan Ineffective Role Performance Definition; A pattern of modulation of the physiologic and behavioral systems of functioning (such as autonomic, motor, state-organizational, self-regulatory, and attentional–interactional systems) in an infant that is satisfactory but that can be improved Make it clear, however, that infant maturation isn’t completely within their control. Explanation may decrease feeling of anxiety and incompetence and help prevent unrealistic expectations.Help parents interpret behavioral cues from their infant to foster healthy parent–child interaction. For example, help them recognize when the infant is awake and alert, and point out to them that this is a good time to provide stimulation.Help parents identify ways they can promote the infant’s develop-ment, such as providing stimulation by shaking a rattle in front of the infant,Nursing Care Plan.

Defining Characteristics

• Use of some self-regulatory behaviors
• Definite sleep–wake states
• Responsiveness to visual and auditory stimuli
• Stable physiologic measures

Related Factors

• Pain
• Immaturity

Assessment Focus

• Elimination
• Role/relationships
• Neurocognition
• Sensation/perception
• Nutrition
• Sleep/rest
• Physical regulation

Expected Outcomes

The Parents Will

• Express understanding of their role in infant’s behavioral develop-ment.
• Express confidence in their ability to interpret infant’s behavioral cues.
• Identify means to promote infant’s behavioral development.
• Express positive feelings about their ability to care for infant.
• Identify resources for help with infant.

The Infant Will

• Maintain physiologic stability.
• Maintain an organized motor system.
• Respond to information in an adaptive way.

Suggested Noc Outcomes

Knowledge: Child Development: 1, 2, 4, 6, and 12 Months; Infant Care; Neurological Status; Sleep

Interventions And Rationales

Determine: Monitor infant’s responses to ensure effectiveness of preventive measures.Perform: Demonstrate appropriate ways of interacting with the infant, such as moderate stimulation, gentle rocking, and quiet vocalizations, to help the parents identify the most effective methods of interacting with their child.199 Inform: Explain to parents that infant maturation is a developmental process. Further explain that infants exhibit three behavioral states: sleeping, crying, and being awake and alert. Also explain that infants provide behavioral cues that indicate their needs. Education will help parents understand the importance of nurturing the infant and prepare them to respond to the infant’s behavioral cues.Explain to parents that their actions can help promote infant development. Make it clear, however, that infant maturation isn’t completely within their control. Explanation may decrease feeling of anxiety and incompetence and help prevent unrealistic expectations.Help parents interpret behavioral cues from their infant to foster healthy parent–child interaction. For example, help them recognize when the infant is awake and alert, and point out to them that this is a good time to provide stimulation.Help parents identify ways they can promote the infant’s develop-ment, such as providing stimulation by shaking a rattle in front of the infant, talking to the infant in a gentle voice, and looking at the infant when feeding him. This encourages practices that promote the infant’s development. Sensory experiences promote cognitive devel-opment.Attend: Explore with parents ways to cope with stress caused by the infant’s behavior to increase their coping skills.Praise parents for their attempts to enhance their interaction with the infant to provide positive reinforcement.Manage: Provide parents with information on sources of support and special infant services to encourage them to continue to foster their infant’s development.

Suggested Nic Interventions

Attachment Promotion; Developmental Care; Environmental Management: Attachment Process; Family Integrity Promotion:Childbearing Family; Infant Care; Sleep Enhancement

Reference

Byers, J. F., et al. (2006, January–February). A quasi-experimental trial on individualized, developmentally supportive family-centered care. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 35(1), 105–115.

Tags: Ineffective role performance, Nanda Ineffective role performance, Nursing care plan, Nursing Care Plan Ineffective role performance

Nursing-CarePlan.com, Nursing Care Plan Ineffective Childbearing Process Definition; A pattern of modulation of the physiologic and behavioral systems of functioning (such as autonomic, motor, state-organizational, self-regulatory, and attentional–interactional systems) in an infant that is satisfactory but that can be improved Monitor infant’s responses to ensure effectiveness of preventive measures.Perform: Demonstrate appropriate ways of interacting with the infant, such as moderate stimulation, gentle rocking, and quiet vocalizations, to help the parents identify the most effective methods of interacting with their child.Explain to parents that infant maturation is a developmental process. Further explain that infants exhibit three behavioral states: sleeping, crying, and being awake and alert. Also explain that infants provide behavioral cues that indicate their needs,Nursing Care Plan.

Defining Characteristics

• Use of some self-regulatory behaviors
• Definite sleep–wake states
• Responsiveness to visual and auditory stimuli
• Stable physiologic measures

Related Factors

• Pain
• Immaturity

Assessment Focus

• Elimination
• Role/relationships
• Neurocognition
• Sensation/perception
• Nutrition
• Sleep/rest
• Physical regulation

Expected Outcomes

The Parents Will

• Express understanding of their role in infant’s behavioral develop-ment.
• Express confidence in their ability to interpret infant’s behavioral cues.
• Identify means to promote infant’s behavioral development.
• Express positive feelings about their ability to care for infant.
• Identify resources for help with infant.

The Infant Will

• Maintain physiologic stability.
• Maintain an organized motor system.
• Respond to information in an adaptive way.

Suggested Noc Outcomes

Knowledge: Child Development: 1, 2, 4, 6, and 12 Months; Infant Care; Neurological Status; Sleep

Interventions And Rationales

Determine: Monitor infant’s responses to ensure effectiveness of preventive measures.Perform: Demonstrate appropriate ways of interacting with the infant, such as moderate stimulation, gentle rocking, and quiet vocalizations, to help the parents identify the most effective methods of interacting with their child.199 Inform: Explain to parents that infant maturation is a developmental process. Further explain that infants exhibit three behavioral states: sleeping, crying, and being awake and alert. Also explain that infants provide behavioral cues that indicate their needs. Education will help parents understand the importance of nurturing the infant and prepare them to respond to the infant’s behavioral cues.Explain to parents that their actions can help promote infant development. Make it clear, however, that infant maturation isn’t completely within their control. Explanation may decrease feeling of anxiety and incompetence and help prevent unrealistic expectations.Help parents interpret behavioral cues from their infant to foster healthy parent–child interaction. For example, help them recognize when the infant is awake and alert, and point out to them that this is a good time to provide stimulation.Help parents identify ways they can promote the infant’s develop-ment, such as providing stimulation by shaking a rattle in front of the infant, talking to the infant in a gentle voice, and looking at the infant when feeding him. This encourages practices that promote the infant’s development. Sensory experiences promote cognitive devel-opment.Attend: Explore with parents ways to cope with stress caused by the infant’s behavior to increase their coping skills.Praise parents for their attempts to enhance their interaction with the infant to provide positive reinforcement.Manage: Provide parents with information on sources of support and special infant services to encourage them to continue to foster their infant’s development.

Suggested Nic Interventions

Attachment Promotion; Developmental Care; Environmental Management: Attachment Process; Family Integrity Promotion:Childbearing Family; Infant Care; Sleep Enhancement

Reference

Byers, J. F., et al. (2006, January–February). A quasi-experimental trial on individualized, developmentally supportive family-centered care. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 35(1), 105–115.

Tags: Ineffective Childbearing Process, Nanda Ineffective Childbearing Process, Nursing care plan, Nursing Care Plan Ineffective Childbearing Process

Nursing-CarePlan.com,Nursing Care Plan Compromised Family CopingDefinition Usually supportive primary person (family member or close friend) provides insufficient, ineffective, or compromised support, comfort,assistance, or encouragement that may be needed by the patient to manage or master adaptive tasks related to health challenge,Manage: Refer to certified childbirth educator for classes on prenatal care, labor & delivery (to include Cesarean birth), breast-feeding,and newborn Direct coping describes any action people take to change an uncomfortable situation, wheres defensive coping denotes the various ways people convince themselves – through a form of self-deception – that they are not really threatened or do not really want something they cannot get.,Nursing Care Plan

Defining Characteristics

• Attempts to assist the patient with unsatisfactory results
• Displays of protective behavior disproportionate to the patient’s abilities or need for autonomy (family member)
• Expresses concern about the family’s response to health problem
• Reports preoccupation with personal reaction to the patient’s health

Related Factors

• Exhaustion of supportive
• Lack of reciprocal support capacity of significant people
• Temporary preoccupation by a
• Incorrect information by a pri- significant person mary person

Assessment Focus

• Behavior
• Coping
• Communication
• Emotional status

Expected Outcomes

The Family Members Will

• Assume responsibility for roles and activities formerly held by the patient.
• Express feelings about assuming responsibility of care for an older family member.

The Patient And Family Members Will

• Identify and make use of appropriate community services.
• Express satisfaction with improved ability to cope with current crisis.

Suggested Noc Outcomes

Caregiver Emotional Health; Caregiver–Patient Relationship; Care-giver Stressors; Family Coping; Family Normalization

Interventions And Rationales

Determine: Identify the primary caregiver in family and assess roles of other family members. Determine usual coping mechanisms employed by this patient and family. Describe patterns of communi-cation used in problem solving. Identify what support systems exist for the family and patient outside the family. Identify strengths and weakness in the family’s communication patterns. Assessment data will assist with establishment of interventions.Perform: Direct development of short- and long-term goals by the patient and family members. Initially, the family members will need 83 help from the caregiver until they understand more about the process of planning.Identify appropriate community services for the family to assist with coping.Inform: Educate patient and family members about the process of aging to assist patient and family to understand how changes in the patient have affected the family.Teach family members ways of maximizing the use of coping strategies that seem to have worked for them in the past. Teach new coping strategies and have family members role model them. Prac-tice will help the family practice the behaviors in real situations.Attend: Avoid becoming involved in a power struggle between patient and family members. The patient may no longer be able to fill ordinary roles and the sudden shift in roles may lead to a power struggle.Encourage family members to express feelings about caring for an older family member. Be nonjudgmental when listening to the family; discuss the issues associated with caring for an older person.If the nurse is judgmental, the family members may not be comfort-able discussing their problem.Provide emotional support for primary caregiver. Some families may hesitate to accept outside help. Other families may be unwilling to make even small sacrifices to care for an older family member. If family members have not been supportive or caring for the elder member before, they are unlikely to change.Manage: Refer to community agencies (e.g., adult day care, respite care, and geriatric outreach services) that can assist the family in caring for the elder. Communicate to the hospice nurse where the patient is at present in coping with the terminal illness.Refer to case manager or social service to assist with ongoing coordination of the patient’s needs after hospitalization.Refer to a member of the clergy or a spiritual counselor when deemed appropriate. Patients will often be more inclined to talk to a spiritual counselor.

Suggested Nic Interventions

Caregiver Support; Coping Enhancement; Family InvolvementPromotion; Respite Care

Reference

Garity, J. (2006). Caring for a family member with Alzheimer’s disease: Cop-ing with caregiver burden post-nursing home placement. Journal of Geron-tological Nursing, 32(6), 39–48.

Tags: Compromised Family Coping, Nanda Compromised Family Coping, Nursing care plan, Nursing Care Plan Compromised Family Coping

Nursing-CarePlan.com, Nursing Care Plan Ineffective Denial Definition; A pattern of preparing for, maintaining and strengthening a healthy pregnancy and childbirth process and care of newborn, Understanding   expectations improves confidence and reduces anxiety.Attend: Assist childbearing family with development of a birth plan.This allows childbearing family to participate in managing the birth experience and promotes communication with the healthcare team.Encourage and support childbearing family throughout the course of the pregnancy to improve self-confidence and promote patient compliance with health recommendations.Manage: Refer to certified childbirth educator for classes on prenatal care, labor & delivery (to include Cesarean birth), breast-feeding,and newborn care.Nursing Care Plan

Defining Characteristics

During Pregnancy

• Reports appropriate prenatal lifestyle, physical preparations; man-aging unpleasant symptoms in pregnancy
• Demonstrates respect for unborn baby
• Reports a realistic birth plan
• Prepares necessary newborn care items
• Seeks necessary knowledge (e.g., of labor & delivery, newborn care)
• Reports availability of support systems
• Has regular prenatal health visits

During Labor & Delivery

• Reports lifestyle that is appropriate for the stage of labor
• Responds appropriately to the onset of labor
• Is proactive in labor & delivery
• Uses relaxation techniques appropriate for the stage of labor
• Demonstrates attachment behavior to the newborn baby
• Utilizes support systems appropriately After birth
• Demonstrates appropriate baby-feeding techniques; basic baby care techniques
• Provides safe environment for the baby
• Reports appropriate lifestyle
• Utilizes support system appropriately

Related Factors

• Prenatal health status
• Obstetrical/medical history (including perinatal risks/complications)
• Cultural beliefs/expectations

Assessment Focus

• Behavior
• Knowledge
• Roles/relationships

Expected Outcomes

The Patient/Childbearing Family Will

• Demonstrate a willingness to maintain/modify his or her lifestyle for optimal prenatal health.
• Convey confidence and knowledge of pregnancy, the labor & delivery process, and newborn care.
• Express appropriate self-control and readily cooperate with recom-mendations of the healthcare team during labor & delivery.
• Exhibit parent–newborn attachment after delivery.
• Meet the newborn’s physical, social, and nutritional needs.

Suggested Noc Outcomes

Prenatal Health Behavior; Knowledge: Pregnancy; Knowledge: Labor & Delivery; Knowledge: Newborn Care; Parent Infant Attachment.

Interventions And Rationales

Determine: Assess baseline knowledge of prenatal self-care, labor & delivery process, and newborn care to identify and resolve knowledge deficits.Perform: Provide written literature on prenatal wellness, labor & delivery expectations, and newborn care. Providing written materials allows adequate time to synthesize and understand new information.Inform: Teach self-care for common prenatal discomforts to promote patient autonomy.Teach childbearing family labor & delivery process and newborn care. Understanding   expectations improves confidence and reduces anxiety.Attend: Assist childbearing family with development of a birth plan.This allows childbearing family to participate in managing the birth experience and promotes communication with the healthcare team.Encourage and support childbearing family throughout the course of the pregnancy to improve self-confidence and promote patient compliance with health recommendations.Manage: Refer to certified childbirth educator for classes on prenatal care, labor & delivery (to include Cesarean birth), breast-feeding,and newborn care. Advanced knowledge of the childbearing process promotes empowerment and positive maternal outcomes.

Suggested Nic Interventions

Anticipatory Guidance; Childbirth Preparation; Emotional Support;Parent Education: Infant, Prenatal Care.

Reference

Ward, S. L., & Hisley, S. M. (2009). Maternal–child nursing care: Optimizing outcomes for mothers, children, and families. Philadelphia: F.A. Davis Com-pany.

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