Update on Glory Ruth

Please keep praying for Glory. This is from her Dad:



I just came home from visiting Glory. she seems to be progressing very well. thank you all for your continued support and prayers. below is a report from Glory's nurse and case manager if you are interested.

One day at a time
Sid


Developmental Care Plan
Glory

Competencies:
Glory is able to attain a steady heart rate, good oxygen saturation and pink color when she is handled, as well as during her quiet time in the isolette. She was positioned on her side with her arms and legs flexed an tucked in close to her body. As Glory moves about in her bed she attempts to selfcalm herself by bringing her hands up to her face and mouth, and by clasping her feet together. At times she pulls her arms and legs in closer to her body for a more secure feeling. Glory also make soft mouthing movements on her feeding tub, which is a sign of hunger,but is also a way for her to calm herself. During alertness she raises her eyebrows to show an interest in socialization.

Sensitivities:
Glory is sensitive to activity around her bedside, with sounds within the nursery, and to handling. She generally breathes at an irregular rate with some retractions seen beneath her rib cage. As she is handled her retractions become deeper and her breathing is faster, but at times she has pauses in her breathing. However, her oxygen saturation remains stable throughout. Although Glory's color is pink, she has an underlying yellowish color (jaundice) to her skin. During handling she becomes slightly mottled in color. Glory exhibits a lot of twitching of her face, body, arms, and legs, both during handling and when she is quiet. This is fairly common for premature infant and should decrease as she stabilizes her breathing, and gets bigger. Glory squirms and stretches, using jerky, flailing movements. She extends her arms out in front of her, as well as spreads her arms wide apart. She also extends her legs and pushes against the blanket. However, she usually tries to pull herself back together by bringing her arms and legs back into flexion. Glory fussed a few times with handling, but generally stayed in a quiet state.

Recommendations:
Thank you for placing Glory in the covered isolette to protect her from environmental stimulation. Position Glory with her arms and legs flexed and tucked in close to the midline of her body. Bring her hands up to her face, and bring her legs together to allow her to self-calm herself. For Glory to touch her own face is the most calming thing she can do for herself. Place her well down into the fold of the snuggle-up to give her close, firm boundaries to push against. Bring the straps of the snuggle-up over her arms and hips to bring he boundaries in closer for a more secure feeling. When placing Glory on her tummy, use the prone positioner to allow he to drop forward for more relaxed shoulders. When handling Glory use frequent handcontainment, by placing one of your hands over her head and the other hand over her hips an legs. Provide this containment prior to handling her to prepare her for a change; during handling to help keep her calm and well regulated; and following handling to help her smoothly transition into deep sleep. Once she is relaxed and going back to sleep attempt to leave her alone until she needs to eat again, or until she needs you to attend to her. Use slow, deliberate motions when handling her, allowing her to set the pace of the care she receives. Encourage the parents to participate in Glory's care, as much as tolerated. Allow them to kangaroo hold (skin-to-skin) each day for extended periods of time to help develop a closer bond. Encourage them to talk to and touch Glory when they visit as their touch is a more loving touch, rather than the working touch of the staff. Provide support and encouragement to the parents as they welcome Glory into their family.

G. M, RN,BSN
Developmental Case Manager