Case Study: Hypoglycemia/Sepsis Baby Boy Bobby Part II Case Study adapted from Perinatal Orientation and Education program 2nd Edition 2009 Association of Women’s Health, obstetric and Neonatal Nurses. Providence Clinical Academy Obstetric Curriculum 2016.06 Case Study adapted from AWHONN Perinatal Orientation and Education Program 3nd Ed.

Baby Boy Bobby Update Baby Boy Bobby had glucose levels as low as 20 and did not resolve. He also had problems dropping his saturation level into the 80’s. He was transferred to the NICU where they started an IV in the scalp and he is now on a CPAP of 6 with an FiO2 of 30. Mom has not been to the NICU, but dad hasn’t left the patient’s bedside. 2016.06 Providence Clinical Academy

Group 1 In transferring mother from L&D to Post Partum mom asks to stop by NICU to sit with her infant. The L&D nurse agrees to take mother to NICU. She wheels mother to the NICU and then leaves her there to sit with her infant. What considerations should be taken to care for this mother? What is the role of the NICU nurse, L&D nurse and Postpartum nurse? What could complicate this situation? 2016.06 Providence Clinical Academy

Group 2 Two days into his NICU stay Baby Bobby is on NC of 1L @21%FiO2 and can breast feed on demand. Mom is having a lot of pain with her C-section incision. She continues to miss opportunities to breast feed her infant. What could be barriers in the mothers ability to breast feed efficiently? What considerations should be considered for this mother to facilitate breast feeding? 2016.06 Providence Clinical Academy

Group 3 After seeing her son for the first time mom returns to Postpartum. She is upset and crying. She tells the postpartum nurse the following: “I couldn’t hold Bobby, there was a machine on his face, and to top it off there was an IV in his brain!” How might you approach calming mom down? What education topics might need to be addressed with mom? Are there any barriers to learning? 2016.06 Providence Clinical Academy

Group 4 Baby Bobby was born by vacuum assisted birth. What are the risks of vacuum delivery How will you monitor Baby Bobby if he is on your unit? 2016.06 Providence Clinical Academy

Group 5 With the symptoms that Baby Bobby is presenting with, what diagnosis are you thinking of? Why? What signs/symptoms would require provider notification? Discharge planning starts at admission. As you prepare for discharge with Baby Bobby, list some discharge criteria that baby Bobby should achieve prior to going home. 2016.06 Providence Clinical Academy