Alteration in Parenting

Alteration
in Parenting

(_)Actual (_)
Potential

Related
To:
[Check
those that apply]
(_)
Abusive
(_) Accident victim
(_) Acutely disabled

(_) Addicted to drugs
(_) Adolescent
(_) Alcoholic
(_) Breastfeeding difficulties
(_) Change in family unit
(_) Economic problems

(_)
Emotionally disturbed
(_) Lack of extended family
(_) Lack of knowledge
(_) Relationship problems
(_) Separation from nuclear family

(_) Single parent
(_) Terminally ill
(_) Unrealistic expectations of self, infant, partner
(_) Other:_____________________________
____________________________________
____________________________________

 

As
evidenced by:
[Check
those that apply]
Major:

(Must be
present
)

(_)
Innappropriate parenting behaviors.
(_) Lack of parental attachment behavior.
Minor:

(
May be
present
)
(_)
Frequent verbalization of dissatisfaction or
disappointment with infant/child.
(_) Verbalization of frustration of role.
(_) Verbalization of perceived or actual inadequacy.

(_) Diminished or inappropriate visual, tactile, or
auditory stimulation.
(_) Evidence of abuse or neglect of child.
(_) Growth and development lag in infant/child.

 

Date &
Sign.
Plan and Outcome
[Check
those that apply]
Target

Date:

Nursing Interventions
[Check
those that apply]
Date
Achieved:
  The
patient will:

(_)
Begin to verbalize positive feelings re: child, self.

(_) Demonstrate
increased attachment behaviors such as holding infant
close, talking to infant, eye contact.

(_) Initiate active
role in child’s care.

(_) Identify
activities that defer and promote successful breast
feeding.

(_) Identify outside
resources for support/guidance:
______________

(_) Demonstrate
ability to care for infant.

(_) Identify support
system.

(_) Other:

 

  (_)
Assess causative or contributing factors.

(_) Eliminate/reduce
contributing factors.

(_) Promote ongoing
attachment process by:_______________
________________________
________________________

(_) Assist to identify
and contact appropriate outside resources.

(_) Will assist
patient to identify support system and assess strengths
and weaknesses.

(_) Provide support to
parents/support system by:____
________________________
________________________

(_) Provide
interventions that promote parents and s/o self esteem.

(_) Counsel the
parent(s) on assessed needs.

(_) Consult
with:______________
________________________
________________________

(_) Encourage
mother/father to feed, diaper, dress, bathe child.

(_) Promote successful
breastfeeding by:

  • proper
    positioning
  • eye to eye
    contact
  • feeding on demand
  • encourage rooming
    in
  • proper latching
    on of infant to breast
  • other

(_)
Other:________________
________________________
________________________
________________________

 

 

__________________________
Patient/Significant other signature

 

__________________________
RN signature