Newborn with a Birth Injury: Nursing Assessment
The proposed case description provides the limited information regarding the state of a newborn. In order to complete an effective assessment of this female newborn and provide the required care, it is necessary to know details about the birth of the infant which are related to possible injuries or traumas experienced by the newborn. The problem is that the observed cephalohematoma can be a result of a birth injury, and it is important to learn details about the labor and delivery processes in order to determine causes of the trauma (Eseonu, Sacino, & Ahn, 2016).
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The examination of the cephalohematoma indicates that there are signs of bruising, and short-term consequences can include additional brain injuries and jaundice. Long-term consequences for the newborn can include developmental disorders. Therefore, the further examination is required in order to prevent the development of problems which are associated with the brain injury. It is possible to state that the assessed infant can have subperiosteal haematoma or cephalohematoma which has developed as a result of the birth injury, and the scleral haemorrhage can be discussed as a sign of this problem (Eseonu et al., 2016). It is important to recommend visiting a doctor in order to monitor the newborn’s state, and it is possible to expect changes in the size of the haematoma. Furthermore, it is also necessary to conduct such tests as computerized tomography and magnetic resonance imaging in order to provide an adequate diagnosis (Eseonu et al., 2016). The treatment should be determined depending on the results of these tests. It is also possible to assume that no specific treatment will be required if there is no evidence of a severe injury, and the infant should be monitored during three months (Eseonu et al., 2016). Jaundice observed in the newborn can be discussed as a result of the cephalohematoma because problems with the blood flow can cause increases in the levels of bilirubin, and this condition is known as hyperbilirubinemia (Bhutani et al., 2013). Furthermore, newborn jaundice is typical of many infants during the first months of their life. Still, it is also important to note that jaundice in this case can also be a result or an indication of some infection which is associated with the cephalohematoma and other factors that should be discussed with the parent (Bhutani et al., 2013; Eseonu et al., 2016). Thus, the differential diagnosis for the condition related to this newborn is jaundice caused by infections because the infant’s axillary temperature is 37.2 C which can be an indicator of a fever. Risk factors for worsening jaundice can be associated with the fact that there was neonatal jaundice, and the cephalohematoma is currently diagnosed (Bhutani et al., 2013). As a result, more details are required to be provided by the mother. In order to determine actual causes of jaundice, it is important to complete the following tests: the measurement of bilirubin levels with the help of blood tests. The test for the complete blood count is also required. As it is reported by the mother, other children had no severe jaundice, and the test to determine the Rhesus factor incompatibility is also required in this case. Depending on the mother’s characteristic provided for her 3-year-old child, it is also important to exclude cases of causing harm to the newborn by other children.
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References Bhutani, V. K., Stark, A. R., Lazzeroni, L. C., Poland, R., Gourley, G. R., Kazmierczak, S.,… Stevenson, D. K. (2013). Predischarge screening for severe neonatal hyperbilirubinemia identifies infants who need phototherapy. The Journal of Pediatrics, 162(3), 477-482. Eseonu, C. I., Sacino, A. N., & Ahn, E. S. (2016). Early surgical intervention for a large newborn cephalohematoma. Pediatric Neurosurgery, 51(4), 210-213.