ISOLATED ROBIN SEQUENCE: NURSING DIAGNOSES

a descriptive study developed in a hospital specialized in craniofacial anomalies and related syndromes, from November 2015 to March 2016. Twenty infants with isolated Robin Sequence participated in the study. For the data collection, the nursing history was used. The nursing diagnoses were listed according to Nanda-International. To compose the results, a descriptive statistical analysis was used.

Results:

eight diagnoses were identified, five of which focused on the problem and three on risk factors, including: risk of aspiration (n=20, 100%); risk of infection (n=20, 100%); ineffective breastfeeding (n=19, 95%); unbalanced nutrition lower than body needs (n=19, 95%); ineffective infant feeding pattern (n=19, 95%); risk of damage to skin integrity (n=18, 90%); ineffective airway clearance (n=11, 55%) and impaired spontaneous ventilation (n=11, 55%).

Conclusion:

infants with isolated Robin Sequence presented nursing diagnoses that were related to respiratory, feeding, safety and comfort problems and favored the planning and implementation of nursing care when tracing a care profile.

DESCRIPTORS:
Nursing Diagnosis; Pierre Robin Syndrome; Nursing; Nursing Processes; Pediatric Nursing

Problem-focused diagnosis	n	%
Ineffective breastfeeding (00104)
Defining characteristics
Unsupported breast suction	15	75
Absence of infant weight gain	1	5
Related factors
Oropharyngeal defect	19	95
Unsatisfactory reflection of infant suction	19	95
Unbalanced nutrition: less than the bodily needs (00002)
Defining characteristics
Perception of the inability to ingest food	19	95
Insufficient muscle tone	18	90
Body weight 20% or more below ideal	1	5
Related factors
Inability to ingest food	19	95
Ineffective infant feeding pattern (00107)
Defining characteristics
Incapacity and coordination of sucking, swallowing and breathing	19	95
Inability to maintain an effective suction	19	95
Inability to initiate an effective suction	15	75
Related factors
Oropharyngeal deformity	19	95
Prematurity	2	10
Ineffective airway clearance (00031)
Defining characteristics
Dyspnea	11	55
Change in the respiratory rate	11	55
Respiratory adventitious noise	4	20
Related factors
Foreign body in the airway	11	55
Excessive mucus	5	25
Impaired Spontaneous Ventilation (00033)
Defining characteristics
Dyspnea	11	55
Increased use of accessory muscles	11	55
Increased heart rate	8	40
Related factors
Respiratory muscle fatigue	11	55

Risk Diagnosis	n	%
Risk of aspiration (00039)
Risk factors
Enteral feeding	19	95
Presence of oral/nasal tube	18	90
Presence of intra-tracheal tube	10	20
Neck surgery	2	10
Risk of infection (00004)
Risk factors
Invasive procedure	20	100
Inadequate vaccination	6	30
Malnutrition	1	5
Risk of injury to the skin integrity (00047)
Risk factors
Extremes of age	20	100
Mechanical factors	18	90
Inadequate nutrition	1	5

Universidade Federal de Santa Catarina, Programa de Pós Graduação em Enfermagem Campus Universitário Trindade, 88040-970 Florianópolis - Santa Catarina - Brasil, Tel.: (55 48) 3721-4915 / (55 48) 3721-9043 - Florianópolis - SC - Brazil
E-mail: textoecontexto@contato.ufsc.br

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[1] Correspondence: Armando dos Santos Trettene, Rua Silvio Marchione, 3-20, 17012-900 - Bauru, SP, Brazil. E-mail: armandotrettene@usp.br