Domain 11. Safety-protection
Class 2. Physical injury
Diagnostic Code: 00156
Nanda label: Risk for sudden infant death
Diagnostic focus: Sudden death
Introduction to Nursing Diagnosis: Risk for Sudden Infant Death
Every parent deeply cares about ensuring their little baby’s safety and wellbeing. One of the greatest health risks newborns face is sudden infant death syndrome (SIDS). It is a feared complication that every parent wants to protect their baby from. That’s why understanding nursing diagnosis, risk factors, at-risk populations, and interventions is essential. While SIDS is not entirely prevented, medical experts have determined risk factors and suggested interventions to help nurses practice safe and protective care.
NANDA Nursing Diagnosis Definition
The North American Nursing Diagnosis Association (NANDA) defines Risk for Sudden Infant Death as an “at-risk diagnosis in a newborn or infant who is likely to die suddenly for no apparent reason”. It is important to recognize that this risk is based on the baby’s level of vulnerability due to environmental, lifestyle, and biological factors. Nurses should practice good standard preventive care so as to lower the baby’s risk for SIDS.
Risk Factors for Unforeseen Sudden Infant Death
There are several risk factors associated with SIDS. Researchers have identified ‘The Big Three’ contributing factors that make up 66% of all cases of SIDS: prenatal smoking, bed-sharing, and sleeping on soft surfaces.
- Prenatal Smoking: Maternal smoking before birth increases the baby’s risk of dying unexpectedly by two to four times. Although it’s advisable for mothers to stop smoking during pregnancy, avoiding it before conception also helps reduce the risk.
- Bed-sharing: When an infant shares a bed or couch with another person, this significantly increases the risk of SIDS. Therefore, healthcare professionals may advise against bed-sharing.
- Soft Sleeping Surfaces: Putting babies on surfaces that are too soft increases the risk of rebreathing or obstruction of the airways. Always ensure the crib’s mattress is firm and does not have any loose pillows or sheets.
Others factors might affect SIDS risk include second-hand smoke, gender, formula-feeding, preterm delivery, and hypoxia.
At-risk Populations
These populations are especially vulnerable to acquiring the diagnostic.
- Minorities: Some research indicates that SIDS is more common among certain minority populations than others. African American infants, for example, are much more prone to SIDS than Caucasian infants.
- Preterm Babies: Babies born before 37 weeks gestational age are at a higher risk of developing SIDS. They are more prone to infections and other conditions that can increase the risk of SIDS.
- Low-Income Families: Lower-income families generally have fewer resources, which can lead to higher levels of stress and poor health outcomes. Studies have proven that poverty and low socioeconomic status are linked to elevated SIDS rates.
Suggestions for Use
Nurses play an important role in the prevention of SIDS. Good practices and supportive measures are critical in reducing the risk of secondary medical complications like SIDS. Nurses need to talk to parents and families about the dangers of bed-sharing, how to properly put their baby to sleep, and how to adequately supply the baby’s thermal needs, among other things. Additionally, nurses need to pay particular attention to at-risk populations and provide individualized patient care.
Suggested Alternative NANDA Nursing Diagnoses
Other NANDA nursing diagnoses can be used as an alternative when assessing a baby’s risks.
- Ineffective Breathing Pattern: This can occur if a baby has a tracheobronchial abnormality or structural airway defect, a disease that alters respiratory effort, or chronic granulomatous disease.
- Lack of Knowledge: If a family has no knowledge or proper understanding of SIDS prevention techniques like safe sleep practices, this puts babies at a greater risk of developing SIDS.
- Altered Comfort: Improper thermal comfort during sleep can be a risk factor for SIDS, particularly if the baby is too hot or too cold.
Usage Tips
When assessing a baby’s risk for SIDS, it’s important for nurses to thoroughly assess for possible risk factors. Take a comprehensive history and include questions about the mother’s smoking habits, sleeping arrangements, breastfeeding, immunizations, alcohol use, and any other concerning behaviors. Evaluate the baby’s growth and development, assess for possible congenital abnormalities, provide education to families on safe sleep practices, and suggest strategies to reduce environmental risk factors.
NOC Outcomes
The following NOC outcomes can be used to measure the baby’s progress in reducing the risks of SIDS.
- Safe Sleep Practice: The baby recognizes, uses, and applies safe sleep practices correctly to reduce the risk of SIDS.
- Thermal Comfort: The baby is able to maintain an appropriate level of thermal comfort during sleep.
- Breathing Pattern: The baby maintains a normal breathing pattern without any difficulty.
Evaluation Objectives and Criteria
When evaluating a baby’s progress in lowering the risk of SIDS, nurses will assess a few key criteria. These objectives include whether the baby is able to:
- Recognize, use, and apply safe sleep practices.
- Maintain an appropriate level of thermal comfort during sleep.
- Maintain a normal breathing pattern without difficulty.
- Develop and maintain adequate nutrition, growth, and development.
NIC Interventions
NIC interventions are tools used by nurses to help prevent SIDS. The following interventions should be implemented as part of the plan of care:
- Smoking Cessation: Educate parents on the risks associated with smoking during and before pregnancy.
- Safe Sleep Practices: Educate parents on safe sleep practices and give reassurance to increase confidence and adherence to preventative strategies.
- Nutrition: Provide nutrition education and resources to maximize developmental potential and improve outcomes.
Nursing Activities
Nurse activities to promote safe sleeping practices and reduce the risk of SIDS include:
- Encourage the use of a firm mattress in the baby’s crib.
- Advise avoiding soft bedding, such as fluffy blankets or stuffed animals.
- Educate parents on how to properly dress their baby, making sure they are neither too hot nor too cold.
- Make sure the baby’s head and face remain uncovered while sleeping.
- Discourage bed-sharing with adults and other children.
Conclusion
It is quite understandable to parents and medical care providers alike to want to eliminate the danger of SIDS. However, due to its unpredictable nature, it can still happen even with the best preventative measures in place. As such, it is most effective for nurses to practice preventive care for optimum safety and reduce the risk factors associated with SIDS. With these interventions and good practices, parents can feel more secure that their baby is well-protected from SIDS and can thrive healthily and happily.
5 FAQs
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