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Case Scenario: Newborn

Gender Male

Age: Neonate

Setting: hospital   

Ethnicity: Black American

Coexisting conditions: Myelomeningocele

Psychosocial: Parental anxiety

Client Profile:

Jerod is the name Joanna and Jim chose for their first child.Jim accompanied Joanna to all of her prenatal visits. When theroutine ultrasound was performed at 32 weeks’ gestation, Jerod wasdiagnosed with hydrocephalus and a myelomeningocele. His parentswere initially devastated, but remained very excited about theirson’s birth. Joanna was scheduled for a caesarean section at 38weeks’ gestation and the couple were anxious about Jerod’scondition and his treatment following birth.

Case Study

Jerod is delivered by caesarean section and transferred to thepediatric intensive care unit (PICU). On admission to the nurseryhe weighs 3.4 kg (7.5 lb) and is 8 cm (20 in.) in length. His vitalsigns are:

  • Temperature: 37° C (98.6° F) Pulse: 144 beats/minuteRespirations: 40 breaths/minute
  • He has bulging fontanels and a high-pitched cry. His headcircumference is 40 cm (15.8 in.) and his chest circumference is 34cm (13.4 in.). In the lumbar region of his spine, the nurse notes asac-like projection. When Joanna and Jim visit the nursery, theystroke Jerod and caress his fingers and toes. Joanna begins to cryand comments to the nurse, “I so wanted to breastfeed Jerod, butnow I guess I can’t.”

1. Discuss the reason for Jerod being delivered by caesareansection.

2. Discuss the significance of Jerod’s clinicalmanifestations.

3. What is hydrocephalus?

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