Case Study 1

Gregory Cahill

Lakeview College of Nursing

May 31, 2012

Instructions:
PEDIATRIC CASE STUDY 1
 
Jesus was the first born son of Roberto and Marie Valez. The parents are both excited about the birth of their new son. They have brought Jesus into their nurse practitioner for his examination three days after his birth.  Jesus was 7 lbs 2 oz at birth and 19 inches. His Apgar scores were 8 and 9. There were no complications with his mothers’ pregnancy or his delivery.  Jesus’ parents noticed that he had lost some weight since he has lost some weight since coming home. Marie has been breastfeeding Jesus and is concerned that she is doing something wrong. They also have several questions about Jesus. (USE APA FORMAT, CITE YOUR SOURCES)          
1.	What can the nurse practitioner tell Marie regarding her concern about Jesus’ weight loss?
2.	What questions should the nurse practitioner ask regarding Jesus’ nutrition, and what information can he or she offer Marie about breastfeeding?
3.	What anticipatory guidance can the nurse practitioner offer to Roberto and Marie regarding Jesus’ growth and development on the next several weeks? 

1.  It is common for a baby to lose 5-10% of their body weight in the first week (Chapman & Durham, 2010).  We do not know the babies current weight so we can not know if his current weight is within normal limits.  
2.  The nurse practitioner should ask the parents the times and for how long the baby breast feeds.  The nurse can inform the parents that breastfed newborns are generally hungry every 90 minutes to 3 hours and will feed 10 to 30 minutes at a time.  It is not uncommon for newborns to fall asleep right after feeding and before they have suckled at the mom’s second breast.  They should not be put on a schedule because they have a stomach capacity of about 30 ml and breast milk is easily digested.  The baby will gradually feed more at one time and the frequency of feeding will decline.  The nurse can also inform the parents that the mother’s body will produce more or less milk depending on Jesus’ needs. (Chapman & Durham, 2010)
3.  After the usual weight lost in the first week of life a newborn gains about 20-30 grams per day and regains birth weight in about 10-14 days.  Most infants will double their weight by 4-6 months old (Kyle & Carman, 2008).

References
Chapman, L., & Durham, R. (2010). Maternal-newborn nursing. Philadelphia, PA: F.A.Davis Company.
Kyle, T., & Carman, S. (2008). Essentials of pediatric nursing. (2nd ed.). Philadelphia, PA: Lippincott Williams & Wilkins.