Practice Reasoning Exemplar
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Practice Reasoning Exemplar
Through the use of practice reasoning, many potential issues can be avoided. Specifically, there was a scenario where a newborn infant loss 12.8% on day 5 during her stay in a maternity facility that potentially could have been avoided if a different care plan was put in place. The woman, G1P1 had a NVB at 40+2 and sustained a PPH of 700mL and a 1st degree tear. She had required a ferrinjet as her Hb was only 82g/L. Her baby girl weighed 3620g and was exclusively breastfeeding. The baby had not PU throughout the whole day though had Pmec with dark green stools. Upon meeting the mother on a night shift at day 3/4 (74 hours post birth), she looked obviously exhausted and reported that baby had been …show more content…
During most of the 2-3 hours, the only way that I could settle the baby was to put a gloved finger into her mouth and let her suck (as recommended by the midwife) though I was afraid that doing so for an extended period would dry out her mucosa. Upon inquiring about her care plan, the midwife acknowledged that the woman appeared to have delayed lactation but she believed that we should just ‘wait and see’ and hope the lactation would arrive soon. Though I disagreed, I was afraid of undermining her care. It was therefore unsurprising to me when the baby had lost 12.8% at day 5 on the day she was to be discharged.
According to practice reasoning, I believed that a different care plan should’ve been set in place much earlier to prevent such a significant weight loss (Pollard, 2012). The baby displayed obvious signs of inadequate milk transfer, specifically referring back to her lack of voiding (and urates in urine when she voided at day 4-5). She was no satiated, her mother had soft breasts and there were no signs of milk transfer during feeding (swallowing signs or visible milk). Once inadequate milk supply has been identified and the cause recognized (in this case, it may have been poor position and latch- tender nipples or effects of PPH – Hb 82g/L), a
Practice Reasoning Exemplar
Through the use of practice reasoning, many potential issues can be avoided. Specifically, there was a scenario where a newborn infant loss 12.8% on day 5 during her stay in a maternity facility that potentially could have been avoided if a different care plan was put in place. The woman, G1P1 had a NVB at 40+2 and sustained a PPH of 700mL and a 1st degree tear. She had required a ferrinjet as her Hb was only 82g/L. Her baby girl weighed 3620g and was exclusively breastfeeding. The baby had not PU throughout the whole day though had Pmec with dark green stools. Upon meeting the mother on a night shift at day 3/4 (74 hours post birth), she looked obviously exhausted and reported that baby had been …show more content…
During most of the 2-3 hours, the only way that I could settle the baby was to put a gloved finger into her mouth and let her suck (as recommended by the midwife) though I was afraid that doing so for an extended period would dry out her mucosa. Upon inquiring about her care plan, the midwife acknowledged that the woman appeared to have delayed lactation but she believed that we should just ‘wait and see’ and hope the lactation would arrive soon. Though I disagreed, I was afraid of undermining her care. It was therefore unsurprising to me when the baby had lost 12.8% at day 5 on the day she was to be discharged.
According to practice reasoning, I believed that a different care plan should’ve been set in place much earlier to prevent such a significant weight loss (Pollard, 2012). The baby displayed obvious signs of inadequate milk transfer, specifically referring back to her lack of voiding (and urates in urine when she voided at day 4-5). She was no satiated, her mother had soft breasts and there were no signs of milk transfer during feeding (swallowing signs or visible milk). Once inadequate milk supply has been identified and the cause recognized (in this case, it may have been poor position and latch- tender nipples or effects of PPH – Hb 82g/L), a