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. Jimaccompanied Joanna to all of her prenatal visits. When the routineultrasound 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 isdelivered by caesarean section and transferred to the pediatricintensive care unit (PICU). On admission to the nursery he weighs3.4 kg (7.5 lb) and is 8 cm (20 in.) in length. His vital signsare: Temperature: 37° C (98.6° F) Pulse: 144 beats/minuteRespirations: 40 breaths/minute He has bulging fontanels and ahigh-pitched cry. His head circumference is 40 cm (15.8 in.) andhis chest circumference is 34 cm (13.4 in.). In the lumbar regionof his spine, the nurse notes a sac-like projection. When Joannaand Jim visit the nursery, they stroke Jerod and caress his fingersand toes. Joanna begins to cry and comments to the nurse, “I sowanted to breastfeed Jerod, but now I guess I can’t.”
7. What are the priorities of care for Jerod on admission?
8. Discuss Jerod’s parents’ actions when visiting Jerod in thenursery and how the nurse should respond to Joanna’s concern aboutbreastfeeding.
9. Discuss the priority nursing interventions when caring forJerod’s myelomeningocele prior to surgery.
