Introduction to ‘Neonatal Hypothermia’ Nursing Diagnosis
Neonatal Hypothermia is a nursing diagnosis used to describe a condition in which an infant’s temperature drops below the normal range. This can be caused by stress, exposure to a cold environment, or insufficiently heated room. When hypothermia occurs in the newborn period, it can lead to serious complications such as respiratory distress syndrome, sepsis, and cardiac arrest. Early recognition and treatment are essential to preventing serious health outcomes.
NANDA Nursing Diagnosis Definition
Neonatal Hypothermia (NDx): Risk for compromised thermal regulation related to immature thermoregulatory control mechanisms or unintended exposure to cold environment.
- Infant reports cold or shivering
- Infant manifests skin mottling
- Infant appears lethargic
- Skin temperature less than 36°C (Axillary)
- Slow capillary refill greater than 3 seconds
- Respiratory rate > 60 bpm
- Restricted access to care
- Environmental/living conditions
- Failure to recognise signs/symptoms
- Maternal physiologic changes
- Untreated maternal infections
- Inadequate nutrition
- Ineffective thermoregulation
Explanation: These related factors can lead to hypothermia in neonates, due to impaired ability to regulate temperature. Maternal infections and physiologic changes can lead to an increase in infectious morbidity and temperature instability; inadequate nutrition can result in decreased energy stores necessary to generate heat; environmental and living conditions can also be a factor due to exposure to cold temperatures; and failure to recognise the symptoms of hypothermia can lead to a delay in diagnosis and treatment.
- Low birth weight infants
- Premature infants
- Infants born in cold climates
Explanation: These high-risk groups can be especially susceptible to hypothermia due to their immature thermoregulatory control mechanisms and lack of fat stores to generate heat. Infants born in cold climates can also experience an increased risk due to extended exposure to cooler temperatures.
- Respiratory Distress Syndrome
- Cardiac Arrest
- Metabolic Acidosis
Explanation: Uncontrolled hypothermia can lead to serious health complications such as respiratory distress syndrome, sepsis, cardiac arrest, and metabolic acidosis. Early detection and intervention are essential to prevent these associated issues.
Suggestions for Use
- Administer warm fluids and medications
- Monitor core temperature
- Utilize radiant warmer
- Provide supplemental oxygen and humidified air
Explanation: To improve an infant’s outcomes when experiencing hypothermia, warm fluids and medications should be administered; core temperature should be monitored; and a radiant warmer, supplemental oxygen, and humidified air may be utilized. These strategies can work together to help restore the body temperature to normal range.
Suggested Alternative NANDA Nursing Diagnoses
- Ineffective Thermoregulation
- Risk for Cold Stress
- Risk for Altered Fluid Volume
Explanation: These alternative diagnoses may also be used to represent an infant’s temperature regulation problems and can be compared and contrasted with the Neonatal Hypothermia diagnosis.
- Document process and associated findings
- Monitor for potential for complications
- Educate parent about signs/symptoms of hypothermia
- Encourage parent to keep newborn warm and dry
- Develop interventions to prevent/treat hypothermia
- Body Temperature Regulation
- Tissue Perfusion
- Cardiac Output
- Parental Satisfaction with Infant Care
Explanation: These NOC outcomes measure progress towards re-stabilizing the core temperature and preserving tissue perfusion, enhancing cardiac output, and improving parental satisfaction regarding care.
- Maternal/Infant Thermal Exchange
- Oxygen Therapy
- Temperature Monitoring
Explanation: These NIC interventions can provide relief from the underlying causes of hypothermia, such as inadequate oxygen levels or inadequate energy stores. Maternal/infant thermal exchange, oxygen therapy, humidification, temperature monitoring, and hyperalimentation can all be used to help re-stabilize an infant’s temperature and improve outcomes.
In conclusion, Neonatal Hypothermia is a nursing diagnosis used to identify infants at risk for a decrease in body temperature regulation. Early detection and treatment are essential to preventing serious health outcomes. The diagnosis is composed of defining characteristics, related factors, a risk population, associated problems, usage tips, NOC outcomes, and NIC interventions. By following the necessary steps, clinicians can help reduce the risks of long-term complications and improve overall outcomes for neonatal patients.
- Which nursing diagnosis applies to neonatal hypothermia? Neonatal Hypothermia (NDx)
- What are the defining characteristics for this diagnosis? Subjective Data: Infant reports cold or shivering; Infant manifests skin mottling; Infant appears lethargic. Objective Data: Skin temperature less than 36°C (Axillary); Slow capillary refill greater than 3 seconds; Respiratory rate > 60 bpm.
- What are some associated problems that can result from untreated hypothermia? Respiratory Distress Syndrome; Sepsis; Cardiac Arrest; Metabolic Acidosis.