Systematization of nursing assistance to a newborn with congenital malformation – Experience report

— Objective: to report the experience of applying nursing care systematization to a Newborn with congenital malformation. Methods: This is a descriptive study, like an experience report. The sample selection followed the non-probabilistic criterion, where the participant was included in the study for convenience. The Nursing Care Systematization was applied to a Newborn with indication for cesarean delivery due to premature amniorrexis and polydramnium and presenting congenital malformation mainly in the face region and who was admitted to the Neonatal Intensive Care Unit in a nursing prescriptions Results: Patient in critical condition, monitored, sedated and the care of a multidisciplinary team in palliative care because his clinical picture with anomalies incompatible with life after the end of the stage, it was reported that the infant died. Conclusion: The Systematization of Nursing Assistance made it possible to plan the creation of a care plan geared specifically to meet the user's demands, through the listed nursing problems, providing quality in the development of care and user satisfaction.


I. INTRODUCTION
The nursing process is a scientific method that is designed to take care of in the best way of human being, based on a care individualized and systematized that provides user observation altogether. In this scenario, use the systematization of nursing care as an essential nursing action to strengthen health care (MARINELLI, SILVA, SILVA, 2015).
Good nursing care is provided by the use of SAE; this tool helps organization of services by providing quality in the care management and work organization process to be developed by the nursing team (SILVA, GARANHANI, PERES, 2015).
Thus, nurse faces a great challenge when structuring and implementing their care practice. Perform nursing actions in perspective of maintaining, restoring and promoting quality of life, is influenced by the organization of activities and services to be developed, besides being weakened by a line of fragmented care by a multidisciplinary team heterogeneous with a predominance of curative and medication practices. (SOARES, 2015).
Furthermore, the cost of care for children with malformation and who need special attention to their needs is a process that requires competence and skill on the part of health professionals, especially nurses, as it requires humanized and resolute assistance that guarantees quality and satisfaction. ( The objective of this study is to report the application of the experience of systematization of nursing assistance (SAE) to a Newborn with bad training congenital.

II. METHODS
This is a descriptive study, with a qualitative approach, an experience report type. The study was carried out through the monitoring and daily volume of a newborn with congenital malformation. The sample selection followed the nonprobabilistic criterion, where the participant was included in the study for convenience. SAE was applied to a newborn with an indication for cesarean delivery due to premature amniorrhexis and polydramnium and presenting congenital malformation mainly in the face region and who was admitted to the neonatal Intensive Care Unit (NICU) in a teaching hospital that is a reference in health maternal and child in the City of Belem-PA / Brazil.
Applied to the SAE clinical nurse the Obstetric Center, along with students from the 9th period of the course Bachelor Nursing a Higher Education Institution who were experiencing supervised in that hospital. The consultation took place on 07/23/2020, shortly after the indication of cesarean delivery of the child's mother.
In order to construct the present report, five specific moments were needed, namely: in the first moment, there www.ijaers.com was a knowledge of the history of gestation of the pregnant woman by the academics, presented by the nurse in the hospital's ward sector. The interns had the opportunity to carry out the client's admission to the infirmary and get to know her background in depth and, then, plan and systematize the nursing care to the client.
Then, in the second moment given the indication of transfer to the Surgical Center, where the delivery took place in a cesarean section, the students were able, together with the whole team and mainly with the help of the nurse, to build a care plan that was carried out by providing transoperative care to better serve the mother and child binomial.
In the third moment, the Nursing Diagnostics of the North American Nursing Diagnosis Association International (NANDA-I) were applied. In the fourth moment, the expected results were designed according to the demand of each problem found during the expenses of nursing care. Finally, in the fifth moment, persistent nursing interventions and prescriptions were scored.

III. RESULTS
It is reported that all available and possible nursing care was carried out, with a view to providing students with learning and showing interest, respect and commitment to the Systematization of Nursing Care for the newborn. The user's SAE is then reported: newborn, born on 7/25/2020, cesarean delivery with cephalic presentation, 39 weeks, weighing 2,888 grams and APGAR 9/9 at birth, 39-week, height of 49 centimeters, head circumference of 33 centimeters, thoracic of 30 centimeters and abdominal of 31 centimeters. He was admitted to the NICU due to the diagnostic impression that, in addition to the congenital malformation, he had neonatal seizure and the Infection Related to Late Health Care by Klebsiella pneumoniae bacteria found by blood culture and Pressure Injury in the Occipital region. Waiting for the Karyotype result to determine the malformation.

First evolution of Nursing:
Lactente Serious infant with congenital malformation, Ramsay 6. On physical examination: clean and intact scalp, with pressure injury in the occipital region. Clean and integrated nostrils and ear. Absence from the eye.

IV. DISCUSSION
Were applied for each nursing problem found A Nursing Diagnosis, calling Standard Affected and the Basic Human the newborn need, as well as its SAE with results Expected and Nursing Interventions. There is, then, the following Assistance Plan. The patient remained in critical condition, monitored, sedated and under the care of the multidisciplinary team in palliative care, as his clinical condition with anomalies were incompatible with life, after the end of the internship, he was informed that the infant died.

V. CONCLUSION
The Nursing Care Systematization made it possible to plan and create a care plan aimed specifically at meeting the user's demands, through the listed nursing problems, providing quality in the development of care and user satisfaction.
This study raises reflections on the importance of SAE in the care of pediatric patients who live with congenital malformation, since these anomalies require differentiated care, with specific care, often at the hospital level, in which nursing care it's essential.
For this to happen, it is necessary to exercise theoretical bases that support nursing actions in their practice, supported by nursing theories, humanization, excellence and indissociation between the theory and practice of care, which have as their starting point the Nursing Process to elaborate the SAE giving quality to the assistance.