Nursing Care Plan Ineffective Infant Feeding Pattern

By On Thursday, August 30th, 2012 Categories : Nanda, Nursing Careplans

0 300x225 Nursing Care Plan Ineffective Infant Feeding PatternNursing Care Plan Ineffective Infant Feeding Pattern 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 Ineffective Infant Feeding Pattern

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 effectivefeeding 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.

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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 hift. An altered bowel elimination pattern may indicate decreased food intake; decreased amounts of concentrated urine may indicate

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 at 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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