Nursing diagnosis – RISK FOR SUDDEN INFANT DEATH SYNDROME

RISK  FOR  SUDDEN  INFANT

DEATH  SYNDROME

DEFINITION

Presence of risk factors for an infant under 1 year of age

RISK FACTORS

Modifiable

• Consistent disorientation to

• Delayed prenatal care

environment

• Infant overheating

Partially Modifiable

• Infant over wrapping

• Low birth weight

• Infants placed to sleep in a

• Prematurity

prone position

• Young maternal age

• Infants placed to sleep in side-

Nonmodifiable

lying position

• Ethnicity

• Lack of prenatal care

• Male gender

• Postnatal infant smoke expo-

• Seasonality of sudden infant

sure

death syndrome (SIDS) (winter

• Prenatal infant smoke

and fall)

• Soft underlayment (loose arti-

• Infant age of 2–4 months

cles in the sleep environment)

ASSESSMENT FOCUS    (Refer  to  comprehensive  assessment  parameters.)

• Sleep/rest

• Roles/responsibilities

• Values/beliefs

EXPECTED OUTCOMES

The parents will

• Be receptive to teaching and guidance.

• Verbalize understanding of risk factors and provide all precautions

possible to prevent disorder.

• Verbalize feelings of preparedness and ability to handle emergen-

cies utilizing CPR techniques and services.

• Exhibit appropriate coping skills in dealing with high-risk infant.

The infant will

• Sleep alone in a crib on a firm sleep surface.

• Maintain normal body temperature as indicated by apnea monitor

worn during sleep.

SUGGESTED NOC OUTCOMES

Knowledge Infant Care; Knowledge Parenting; Parent Performance;

Risk Control; Risk Detection

INTERVENTIONS AND RATIONALES

Determine: Assess prenatal history; maternal history; parental experi-

ence; monitor heart rate, blood pressure; respiratory rate, quality,

depth of respirations, breath sounds; reflexes, response to touch. The

assessment information will assist in identifying appropriate

interventions.

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Perform: Position infant on back when placed in the crib. Incidence

of SIDS is higher when infant is placed in a prone position.

Elevate infant’s head slightly when placed in the crib to decrease

abdominal pressure on diaphragm and allow better expansion of lungs.

Place infant on a firm sleep surface to prevent him or her from

sinking into the mattress cover or blanket.

Maintain room at appropriate temperature and avoid wrapping

the infant in heavy blankets. Excessive heat has been identified as a

possible risk factor.

Inform: Educate parents about risk factors of SIDS because modifica-

tion of current practices can reduce risk and prevent occurrence.

Instruct caregivers on ways to maintain a safe environment in the

home. Provide written information to caregivers on all important

aspects of the infant’s care.

Teach parents to avoid having loose blankets, toys, or other arti-

cles in the crib to decrease risk of accidental suffocation.

Encourage mother to breast-feed because there is a lower

incidence of SIDS in babies who are breast-fed.

Teach parents how to correctly apply leads and set alarms of the

apnea monitor. The benefit of the monitor can be achieved only if it

is used correctly.

Instruct parents in CPR to reduce anxiety and promote confidence

in performing correct technique. Allow time for return

demonstrations to prepare parents to cope with infant when he or

she returns home.

Attend: Encourage parents in their efforts to care for the infant. Pro-

vide suggestions for coping mechanisms to help reduce the anxieties

associated with caring for a high-risk infant. Be aware that parents

may be sensitive to your unspoken feelings about the situation.

Encourage parents to interact with other parents managing high-

risk infants well. Peer support may help to reduce fear in the parents.

Involve parents in planning and decision making for their infant.

Investment in decision making will promote compliance with the plan.

Manage: Refer to case manager/social worker/home health agency to

ensure that parents receive adequate support in caring for the infant.

Refer parents to support group if one is available.

SUGGESTED NIC INTERVENTIONS

Family Support; Infant Care; Risk Control

Reference

Thogmartin, J. R., et al. (2001).  Sleep position and bed-sharing in sudden

infant deaths and examination of autopsy findings. Journal of Pediatrics,
138(20), 212–217.

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