Atkin's Case B4

ATKINS CASE

1. The Atkinses are the family you met at the beginning of the chapter. Mrs. Atkins does not
want to visit or “waste her favorite name” on her new baby because the baby might die.
How would you advise her?
 We will make her understand that the baby is an individual and we are trying to
save the baby from dying. Then, we will tell her “how can you behave like this
think that if the baby survive, and grows up? Think when you are old and if your
health care provider think you are going to die and not take care of you. How do
you feel? We are here to support and take care of you and your baby. We will
treat the baby as an individual till he becomes better or till he die.”

2. Infants who are cared for in neonatal nurseries may need either reduced stimulation
because they fatigue so easily or increased stimulation because their stay in the nursery
will be so extended. What are examples of developmental care you might use with Baby
Atkins?
 For the problem like what the family Atkins faced regarding their newborn,
developmental care for the baby should be provided the following:
 Respiratory support - Oxygenation can be maintained by delivering
oxygen via bag/mask, nasal cannula, oxygen hood, nasal continuous
positive airway pressure (N-CPAP), or ventilator support. Resuscitation
with 100% oxygen may increase neonatal mortality compared with
ambient air.13 Blended oxygen, with the fraction of inspired oxygen
ranging from 21% to 50% oxygen, stabilizes premature newborns, and
pulse oximetry monitors are used to maintain saturations around 90%.
 Surfactant Replacement ophylactic and rescue therapy with natural
surfactants in newborns with RDS reduces air leaks and mortality.
Neonatal type II pneumocytes produce surfactant in the third trimester to
prepare for air breathing. Without surfactant, there is higher pulmonary
surface tension, atelectasis, and ventilation/perfusion mismatch resulting
in hypoxia, hypercapnia, and acidosis.
 Other support - Adequate fluid and electrolyte balance should be
maintained. Oral feedings are withheld if the respiratory rate exceeds 60
respirations per minute to prevent aspiration. A neutral thermal
environment reduces the newborn's energy requirements and oxygen
consumption. If the illness exceeds the clinician's expertise and comfort
level or the diagnosis is unclear in a critically ill newborn, neonatology
should be consulted.

3. Retinopathy of prematurity is an example of a disease caused by the therapy given an

infant. What measures would you take to safeguard Baby Atkins against this disorder?
 Give optimum oxygen, which is adequate for the brain and heart, and minimum
required for the vessels of retina
 Check the oxygen nobe and the amount of oxygen supplied every 2 hours.
4. Examine the National Health Goals related to high-risk newborns. Most government-
sponsored funds for nursing research are allotted based on these goals. What would be a
possible research topic to explore pertinent to these goals that would be applicable to the
Atkins family and also advance evidence-based practice?
 National Health Goals
 Reduce low birth weight (LBW) to an incidence of no more than 5% of live
births and very low birth weight (VLBW) to an incidence of no more than
0.9% of live births from baselines of 7.6% and 1.4%, respectively.
 Increase the proportion of very low birth weight (VLBW) infants born at level
III hospitals or subspecialty perinatal centers from a baseline of 73% to a
target level of 90%.
 Reduce the rate of fetal and infant deaths during the perinatal period (28
weeks of gestation to 7 days or more after birth) to 4.4 per 1000 live births
from a baseline of 7.3 per 1000 live births.
 Reduce the rate of deaths from sudden infant death syndrome (SIDS) to 0.23
per 1000 live births from a baseline of 0.67 per 1000 live births
 Main research topic to explore the goals applicable to the Atkin’s family
 Identifying women at risk of preterm birth with low birth weight infants
(LBW) and very low birth weight infants (VLBW)
 Other research topics that may be explored

 Measures that can make parents feel most comfortable and allow them to best
interact with their infants in neonatal intensive care units
 Strategies to increase the proportion of women delivering a live birth who
received preconception care services and practiced key recommended
preconception health behaviors
 Effective developmental care that can help prevent conditions such as apnea,
intraventricular hemorrhage, and periventricular leukomalacia on preterm
infants
 Knowledge deficit on preterm infant care and its effects on family-infant
bonding
 Delaying infant birth until term and its effects on future infant health

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ATKINS CASE

3. Retinopathy of prematurity is an example of a disease caused by the therapy given an

 Other research topics that may be explored

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