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Information

  1. GENERAL ASPECTS
    1. The high-risk infant has the same developmental needs as the healthy term infant:
      1. Social and tactile stimulation.
      2. Comfort and removal of discomfort (hunger, soiling).
      3. Continuous contact with a consistent, parenting person.
    2. Treatment for serious physiological compromise may result in:
      1. Isolation.
      2. Sensory deprivation or noxious stimuli.
      3. Emotional stress.
  2. ASSESSMENT—signs of neonatal emotional stress:
    1. Does not look at person performing care.
    2. Does not cry or protest.
    3. Poor weight gain; failure to thrive.
  3. ANALYSIS/NURSING DIAGNOSIS: sensory-perceptual alterations related to isolation in isolette, oxygen hood.
  4. NURSING CARE PLAN/IMPLEMENTATION:
    1. Goal: provide consistent parenting contact. Assign same nurses whenever possible.
    2. Goal: emotional support.
      1. Comfort when crying.
      2. Provide positive sensory stimulation. Arrange time to:
        1. Stroke skin.
        2. Hold hand.
        3. Hum, sing, talk.
        4. Hold in en-face position (nurse looking into infant's eyes).
        5. Hold when feeding, if possible.
    3. Goal: encourage parents to participate in care—to:
      1. Reduce their psychological stress, anxiety, fear.
      2. Promote bonding.
      3. Reduce possibility of later child abuse (higher incidence of child abuse against children who have been high-risk infants).
  5. EVALUATION/OUTCOME CRITERIA:
    1. Infant demonstrates successful resolution of physiological problems.
    2. Parents and infant evidence bonding.
    3. Parents express satisfaction with care and result.