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Ineffective Thermoregulation related to Asphyxia Neonatorum

Nursing Care Plan for Asphyxia Neonatorum

Neonatal asphyxia is a condition in newborns who fail to breathe spontaneously and regularly soon after birth.

Signs and Symptoms
  1. Hypoxia.
  2. Respiration rate of more than 60 x / min or less than 30 x / min.
  3. Gasping breath until respiratory arrest may occur.
  4. Bradycardia.
  5. The reduced muscle tone.
  6. Cyanotic skin color / pale.
Diagnostic examination
  1. Blood Gas Analysis.
  2. Blood electrolytes.
  3. Blood sugar.
  4. Baby grams (chest X-ray).
  5. Ultrasound (head).

Nursing Diagnosis : 

Ineffective thermoregulation related to temperature regulation system is not inadequate.

Nursing Outcomes :

Thermoregulation: neonate

Indicators:
Normal body temperature

Assessment scale:
1. Extremely compromised.
2. Substantially compromised.
3. Moderately compromised.
4. Mildly compromised.
5. Not compromised.

Nursing Interventions

Temperature regulation
  • Place the baby in a warm temperature environments.
  • Monitor axillary temperature in infants unstable.
  • Monitor signs of hypothermia: fatigue, weakness, discoloration, skin.
  • Avoid situations that may cause the baby to lose heat, such as exposure to cold air, window or shower.

Rationale :
  • Maintaining the temperature of the baby's body.
  • Monitor the baby's body temperature.
  • Avoiding heat loss through conduction.

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