Nursing diagnoses in primary health care consultations to newborns

Descriptive, analytical and quantitative study performed in a primary health care clinic in São Paulo. Data were collected from the medical records of 37 children treated in 39 nursing consultations during their neonatal period. The identified nursing diagnoses were analyzed regarding: frequency, classification in strengthening or exhaustion in light of the health-disease process, and the correspondence with the essential needs of infants.

Results:

372 diagnoses were identified, most of them of strengthening (71%), such as efficient development (n = 37) and effective growth (n = 36). Among the exhaustion diagnoses (29%), there was a predominance of risk for suffocation (n = 15) and impaired tissue integrity (n = 14). Most diagnoses corresponded to the need of physical protection and security.

Conclusion:

Families are strengthened in the care of the essential needs of newborns, however, preventing diseases is necessary.

Descriptors:
Nursing Diagnosis; Primary Health Care; Infant, Newborn; Child Development; Health Promotion

Nursing diagnoses indicating strengthening in view of the health-disease process	Frequency of the diagnosis (n)	% of the diagnosis in total	% of children with the diagnosis
Need for physical and safety protection
Effective newborn development	37	14.0	100.0
Effective growth	36	13.6	97.3
Effective evacuation	33	12.5	89.2
Adequate sleep	31	11.7	83.8
Exclusive breastfeeding	28	10.6	75.7
Adherence to immunization regime	26	9.9	70.3
Adherence to supplementation regime	11	4.2	29.7
Proper hygiene	9	3.4	24.3
Adherence to therapeutic regime (sunbathing)	7	2.7	18.9
Adherence to care for safe sleep	3	1.1	8.1
Others^* * nursing diagnoses that appeared only once: positive breastfeeding, suitable dilution of milk formula, effective eating pattern, effective breathing pattern.	4	1.5	2.7
Need for ongoing nurturing relationships
Effective bonding	20	7.6	54.1
Effective parent role	19	7.2	51.4
Total	264	100.0

Nursing diagnoses that indicate wastage in view of the health-disease process	Frequency of the diagnosis (n)	% of the diagnosis in total	% of children with the diagnosis
Need for physical and safety protection
Risk for suffocation	15	13.9	40.5
Impaired tissue integrity	14	13.0	35.1
Risk for fall	11	10.2	29.7
Impaired hygiene of the umbilical cord stump	8	7.4	21.6
Ineffective oral hygiene	4	3.7	10.8
Impaired sleep	4	3.7	10.8
Ineffective adherence to supplementation regime	4	3.7	10.8
Impaired breastfeeding	4	3.7	10.8
Impaired knowledge on therapeutic regime	4	3.7	10.8
Risk for infant sudden death	4	3.7	10.8
Interrupted breastfeeding	3	2.8	8.1
Newborn colic	3	2.8	8.1
Altered genital hygiene	3	2.8	8.1
Ineffective adherence to the therapeutic regime (sunbathing)	3	2.8	8.1
Impaired knowledge on oral care	2	1.8	5.4
Impaired growth (insufficient weight gain)	2	1.8	5.4
Impaired nutritional intake	2	1.8	5.4
Risk for low weight	2	1.8	5.4
Risk for interrupted breastfeeding	2	1.8	5.4
Others^* Note:	7	6.5	2.7
Need for ongoing nurturing relationships
Impaired family process	3	2.8	8.1
Others^** * nursing diagnoses that appeared more than once: adherence to care for ineffective safe sleep, impaired urinary elimination, heat rash, hematoma, impaired hygiene, infection perceived in left eye, risk for impaired development;	3	2.8	8.1
Need for stable and supporting communities
Inadequate house security	1	0.9	2.7
Total	108	100

Clinical and sociodemographic characteristics of newborns	Wastage nursing diagnoses in view of the health-disease process		p value	Confidence interval (95%)
Clinical and sociodemographic characteristics of newborns	>Yes (n=31)	No (n=6)	p value	Confidence interval (95%)
Age in days (mean and standard deviation)	14.3 (6.2)	20.1 (5.6)	0.03
Gender
Female	17 (54.8%)	2 (33.3%)	0.4	[0.09-2.27]
Male	14 (45.2%)	4 (66.7%)
Type of delivery
Normal	22 (71%)	3 (50%)	0.3	[0.49-8.83]
Cesarean section	9 (29%)	3 (50%)
Low birth weight (< 2,500 g)
No	27 (96.4%)	3(100%)
Yes	1 (3.6%)	0 (0%)	1	[indefinido]
Full term birth
No	4 (13.8%)	0 (0%)	1	[indefinido]
Yes	25 (86.2%)	6 (100%)
Neonatal hospitalization
No	25 (86.2%)	4 (100%)
Yes	4 (13.8%)	0 (0%)	1	[indefinido]
Family type
Nuclear or expanded	27 (87.1%)	5 (100%)	1	[indefinido]
Single parent family	4 (12.9%)	0 (0%)

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[1] CORRESPONDING AUTHOR: Priscila Costa. E-mail: priscila.costa@unifesp.br