Discuss the impact on the family if the twins are in different hospitals. Describe how you can support Jane & Peter.
What are your responsibilities in preparing Andrew for transfer to the NICU?
Will like current reference within the last 5 years and also my require texts should be part of my reference. Please focus on the family centred approach in all responses to questions.
Gardner, S., Carter, B., Enzman-Hines, M., & Hernandez, J. (2011). Merenstein & Gardner’s Handbook of Neonatal Care. St Louis: Mosby Elsevier.
Lissauer, T., Fanaroff, A. , Miall, L., & Fanaroff, J (2016). Neonatology at a glance. Third Edition. United Kingdom: Wiley-Blackwell.
The purpose of this assignment is to encourage critical analysis and reflection on practice. Keep in mind that the focus of this course is primarily neonatal nursing care in the context of ‘special care’. The neonatal nurse’s /midwife’s role in ‘collaborative care’ or ‘teamwork’ should be addressed whilst remembering that although central, the medical aspect of care is not the focus of your paper.
This assignment consists of a scenario in three parts for your consideration. You should reflect on the scenario and respond to the questions related to it. Imagine the scenario in your practice context and think about your actions in response to the events that are described. Utilise the literature to inform and support your responses. It is suggested that you answer one section at a time and build on that response as more information becomes available to you.
It is expected that you will focus on the professional role of the midwife /registered nurse in Special Care Nursery as you outline the proposed implementation of care for James, Andrew and their family. You should also reflect on and review the possible differential diagnosis for James and Andrew.
For this assignment you should ensure:
• All questions in part A, B and C are answered.
• Reference is made to your particular clinical context.
• Appropriate literature is referred to, to inform and support responses to the described events.
• Information is presented in a clear and concise manner.
• Pathophysiology is correctly explained and understood.
• Principles of family centred care are addressed and discussed.
• The neonatal nurse’s / midwife’s role in collaborative care is demonstrated
Word Limit: 2000 – Assignment 2: Part A
It is 4am and you are the midwife/registered nurse in-charge of the Special Care Nursery (SCN) at the local hospital. The nursery is quiet, and has 7 infants and you have one other midwife / registered nurse working with you.
Jane arrives unexpectedly at the Birth Suite. This is Jane’s first pregnancy; she is 33.2 weeks gestation with a twin pregnancy and is in established labour.
Following review, staff in the Birth Suite informs you that Jane is nearly fully dilated and will birth soon. Jane is accompanied by her husband Peter.
You are asked to be present at the birth to assist with the resuscitation and care for Jane’s babies following birth.
Outline what you need to do to prepare for the birth and admission of Jane’s babies to the SCN. Provide your rationale for the actions you identify.
What additional information do you need to consider in this scenario?
Assignment 2: Part B
Jane progresses quickly and the first baby is delivered. The first twin, a boy requires minimal resuscitation at birth, only warmth and stimulation. The baby is given an Apgar score of 7 at 1 minute and 9 at 5 minutes.
The second twin also a boy is born 8 minutes later. He required some resuscitation, including warmth, stimulation and a brief period of positive pressure ventilation delivered via a face mask and a t-piece device. The second twin is given an Apgar score of 6 at 1 minute and 8 at 5 minutes.
The babies are shown briefly to their parents before they are transferred to the SCN. You admit the babies to the SCN. On arrival the second twin is noted to have grunting respirations, nasal flaring and chest recession.
Discuss your priorities as the midwife/ registered nurse during the admission and stabilization process. Provide your rationale for the actions you identify.
Following their admission to the SCN what ongoing care would you provide for the babies and their family?
Assignment 2: Part C
The first twin called James by his parents, is placed in an isolette for observation and has acceptable oxygen saturations in room air and has no signs of respiratory distress.
The second baby, called Andrew by his parents, is initially placed in 30% head box oxygen to maintain his oxygen saturations within an acceptable range. He is placed on nil orally and has an intravenous cannula inserted and is commenced on IV fluids of 10% dextrose at 80 mls /kg/day.
Over the morning Andrew has increasing tachypnoea, with increasing oxygen requirements, and by 12md is requiring 60% oxygen to maintain his oxygen saturations. You call the medical officer to review Andrew. While waiting for the medical officer to arrive, Andrew has an apnoeic episode.
Following examination and review by the medical officer the decision is made to arrange the transfer of Andrew to a tertiary Neonatal Intensive Care Unit (NICU).
Jane and Peter are contacted to inform them of Andrew’s changing condition and the plans to transfer him to a NICU.
Outline the possible differential diagnosis and management strategies for Andrew at this time. Support the response with relevant literature.
Discuss the impact on the family if the twins are in different hospitals. Describe how you can support Jane & Peter.
What are your responsibilities in preparing Andrew for transfer to the NICU?
Marking Criteria
Exceptional presentation. High level of analysis of problem identification. Coherent and logical, clear and concise analysis of the literature. Aligns to best practice. Demonstrates higher order thinking abilities. Exceptional. Very well presented and superbly written. Clear concise analysis, synthesis and critical evaluation of the literature. Independent and original thought to bring the analysis to a logical conclusion. Excellent understanding of pathophysiology and its implications. Excellent understanding and use of the family centred approach in all responses to questions. Excellent understanding of the SCN Nurse’s role in collaborative practice with eloquent discussion on the role of the NICU Nurse.
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