Nurse's Pocket Guide

disorganized INFANT BEHAVIOR
LIGHT/VISION
• Reduce lighting perceived by infant; introduce diurnal lighting
(and activity) when infant achieves physiological stability.
(Daylight levels of 20 to 30 candles and night light levels of
less than 10 candles are suggested.) Change light levels gradually
to allow infant time to adjust.
• Protect the infant’s eyes from bright illumination during
examinations/procedures, as well as from indirect sources,
such as neighboring phototherapy treatments, to prevent
retinal damage.
• Deliver phototherapy (when required) with Biliblanket
devices if available (alleviates need for eye patches).
• Provide caregiver face (preferably parent’s) as visual stimulus
when infant shows readiness (awake, attentive).
SOUND
• Identify sources of noise in environment and eliminate or
reduce (e.g., speak in a low voice; reduce volume on
alarms/telephones to safe but not excessive volume; pad metal
trash can lids; open paper packages, such as IV tubing and suction
catheters, slowly and at a distance from bedside; conduct
rounds/report away from bedside; place soft/thick fabric, such
as blanket rolls and toys, near infant’s head to absorb sound).
• Keep all incubator portholes closed, closing with two hands to
avoid loud snap with closure and associated startle response.
• Refrain from playing musical toys or tape players inside incubator.
• Avoid placing items on top of incubator; if necessary to do so,
pad surface well.
• Conduct regular decibel checks of interior noise level in incubator
(recommended not to exceed 60 dB).
• Provide auditory stimulation to console, support infant
before and through handling or to reinforce restfulness.
OLFACTORY
• Be cautious in exposing infant to strong odors (e.g., alcohol,
Betadine, perfumes), as olfactory capability of the infant is
very sensitive.
• Place a cloth or gauze pad scented with milk near the infant’s
face during gavage feeding. Enhances association of milk
with act of feeding/gastric fullness.
• Invite parents to leave a handkerchief that they have scented
by wearing close to their body near infant. Strengthens infant
recognition of parents.
Information in brackets added by the authors to clarify and enhance
the use of nursing diagnoses.
400 Cultural Collaborative Community/Home Care