Transient tachypnea TTN

Transient Tachypnea TTN 4 Nursing Care Plans Diagnosis and Interventions

Transient tachypnea TTN NCLEX Review Care Plans

Nursing Study Guide on Transient Tachypnea of the Newborn (TTN)

Transient tachypnea of the newborn (TTN) is a respiratory condition that can affect babies during a few hours of life and may last for 3 days or less.

The word “transient” means short-term, while “tachypnea” is a medical term for increased respiratory rate. TTN is a common cause of admission of babies into neonatal intensive care units. It is important to note that only a small percentage of newborns experience TTN.

However, tachypnea or rapid breathing may be a symptom of many other respiratory conditions which could be more serious or life-threatening, so it is important for the child to be assessed thoroughly by a healthcare provider.

Signs and Symptoms of Transient Tachypnea of the Newborn (TTN)

  • Tachypnea – rapid breathing rate higher than 60 breaths per minutes
  • Nasal flaring
  • Grunting sounds when breathing
  • Labored breathing by means of pulling in at the ribs

Causes and Risk Factors of Transient Tachypnea of the Newborn (TTN)

Babies have fluids in their lungs while still in the womb. The hormonal changes prior to birth may contribute to a baby’s tendency to reabsorb fluid in the lungs.

This process of reabsorption of liquid continues during delivery, as the baby passes through the birth canal. The baby starts to breath on his/her own once born, and the fluid in the lungs render him/her unable to inspire oxygen very well.

As a result, the baby compensates by breathing faster and harder (tachypnea) to inhale more oxygen to be delivered into the lungs.

The risk factors for TTN include:

  • Age when delivered – most cases of TTN involve full-term babies, although it can also happen to premature babies
  • Babies born through Caesarean section

Diagnosis of Transient Tachypnea of the Newborn (TTN)

  1. Physical examination
  2. Chest X-ray – the lungs appear to be overinflated and streaked in a baby with TTN; imaging can rule out other conditions, such as respiratory distress syndrome, pneumonia, or other infections
  3. Blood tests – arterial blood gases (ABG) blood tests are done daily to check for the oxygen and carbon dioxide levels in the newborn’s blood; elevated white blood cell counts may indicate the presence of a lung infection
  4. When symptoms are relieved on their own during the first few hours of life, the child will have TTN as a confirmed diagnosis

Treatment for Transient Tachypnea of the Newborn (TTN)

  1. Monitoring. Most cases of TTN resolve on their own within 3 days after being born. These cases only require close monitoring for any presence of respiratory distress or infection.
  2. Oxygen therapy. The baby with low oxygen levels may be given supplemental oxygen through the use of nasal cannula or mask.
  3. Continuous positive airway pressure (CPAP). This treatment is done using a mechanical ventilator when the baby has severe difficulty of breathing and poorly inflated lungs.
  4. Intravenous fluid therapy. Newborns who have rapid breathing may have trouble eating at the same time, so they might require intravenous hydration and nutrition if the TTN does not resolve in the first few hours of life.
  5. Hold feeding or commence tube feeding. The feeding can be postponed for the first few hours while the infant has TTN. If the TTN does not resolve within 24 hours after delivery, the baby might need to be fed via a nasogastric tube for nutrition if the difficulty breathing is present or is not resolving.

Nursing Care Plans for Transient Tachypnea of the Newborn (TTN)

Nursing Care Plan 1

Nursing Diagnosis: Ineffective Breathing Pattern related to transient tachypnea of the newborn (TTN) as evidenced by rapid breathing of 65 breaths per minute, SpO2 of 90% on room air, nasal flaring, and grunting sounds while breathing

Desired Outcome: The newborn will achieve effective breathing pattern as evidenced by respiratory rates between 40 to 60 breaths per minute, oxygen saturation within the target range (usually greater or equal to 93%), and appearance of ease of breathing without any grunting sounds.

InterventionsRationales
Assess the infant’s vital signs and characteristics of respirations at least every 30 to 60 minutes within the first 4 to 6 hours of life.To monitor the newborn’s respiratory status and to check for the effectiveness of medical treatment.
Administer supplemental oxygen, as prescribed. Discontinue if SpO2 level is within the target range, or as ordered by the physician.To increase the oxygen level and achieve an SpO2 value within the target range.
Perform diagnostic tests such as ABG blood tests and chest xy-ray as indicated by the physician.Chest X-ray – the lungs appear to be overinflated and streaked in a baby with TTN; imaging can rule out other conditions, such as respiratory distress syndrome, pneumonia, or other infectionsBlood tests – arterial blood gases (ABG) blood tests are done daily to check for the oxygen and carbon dioxide levels in the newborn’s blood; elevated white blood cell counts may indicate the presence of a lung infection  
If the infant’s oxygen saturation and respiratory rate does not improve or worsen, establish an intravenous line.To enable intravenous delivery of fluids and medications as needed.
If the infant’s oxygen saturation and respiratory rate worsen, consider CPAP treatment.Continuous positive airway pressure (CPAP) is done using a mechanical ventilator when the baby has severe difficulty of breathing and poorly inflated lungs.  

Nursing Care Plan 2

Nursing Diagnosis: Impaired Gas Exchange related to transient tachypnea of the newborn (TTN) as evidenced by shortness of breath, fast and labored breathing and oxygen saturation of 88%

Desired Outcome: The infant will demonstrate adequate oxygenation as evidenced by an oxygen saturation within the target range set by the physician as well as normal ABG levels.

InterventionsRationales
Assess the infant’s vital signs, especially the respiratory rate and depth. Auscultate the lungs and monitor for wheezing or other abnormal breath sounds.To create a baseline set of observations for the infant, and to monitor any changes in the vital signs as the patient receives medical treatment.
Monitor the color of skin and mucous membrane.Central cyanosis involving the mucosa (such as the lips) may indicate further reduction of oxygen levels. Peripheral cyanosis (bluish discoloration of the skin, ear lobes, or nail beds) may be evident with hypoxemia.
Monitor blood chemistry and arterial blood gases (ABG levels).Respiratory acidosis and hypoxemia are evidenced by increasing PaCO2 and decreasing PaO2. Decreasing oxygen saturation levels mean hypoxia.
Assist the physician to initiate intubation and mechanical ventilation of the patient, if required.To maintain adequate oxygen supply by delivering proper ventilation and oxygenation while allowing the lungs to inflate on their own.

Nursing Care Plan 3

Nursing Diagnosis: Deficient Knowledge related to the diagnosis of TTN as evidenced by the parent’s verbalization of “Can you explain what is happening with my child?”

Desired Outcome: At the end of the health teaching session, the patient will be able to demonstrate sufficient knowledge of TTN and its management.

InterventionsRationales
Assess the parent’s readiness to learn, misconceptions, and blocks to learning.To address the parent’s cognition and mental status towards the diagnosis of TTN and to help the patient overcome blocks to learning.
Explain what TTN is, its cause, diagnostic procedures, and its management. Avoid using medical jargons and explain in layman’s terms.To provide information on TTN and its pathophysiology in the simplest way possible.
Educate the parent about the possible need to provide hydration and nutrition through an intravenous line or tube feeding.Newborns who have rapid breathing may have trouble eating at the same time, so they might require intravenous hydration and nutrition if the TTN does not resolve in the first few hours of life. If the TTN does not resolve within 24 hours after delivery, the baby might need to be fed via a nasogastric tube for nutrition if the difficulty breathing is present or is not resolving.  
Educate the parent or guardian about the need for mechanical ventilation if it is required.Continuous positive airway pressure (CPAP) is done using a mechanical ventilator when the baby has severe difficulty of breathing and poorly inflated lungs.  
Re-assure the parent or guardian that TTN usually resolves within 3 days after birth.To alleviate anxiety of the parent or guardian.

Nursing Care Plan 4

Nursing Diagnosis: Anxiety of the mother related to diagnosis of TTN as evidenced by panicking, restlessness, shortness of breath, disorganized thought process, and crying

Desired Outcome: The mother will be able to reduce her own anxiety level.

InterventionRationale
Assess the anxiety level of the mother by asking open-ended questions about how he/she thinks or feels about the situation.To establish a baseline observation of the anxiety level of the mother Open-ended questions can help explore the thoughts and feelings of the patient regarding the situational crisis.
Ensure to speak in a calm and non-threatening manner to the patient. Maintain eye contact when communicating with her. Provide a comfortable environment by providing sufficient lighting, good ventilation, and reduced noise levels. Respect the personal space of the client but sit not too far from her.A calm voice and a comfortable environment can help the patient feel secured and comfortable to speak about her worries and fears. The client may become more relaxed and open for discussion if she sees the nurse as calm and appears to be in control.
Provide a supportive approach by giving the mother enough time to speak and process the situation, as well as providing simple and short answers to her questions.The mother may have a limited attention span and is irritable or restless because of pain and fatigue after giving birth as well as the additional stress of having an unwell infant, thus giving the mother enough time to speak and process the situation, as well as providing simple and short answers to her questions are important in helping the parent cope with the situation.
Teach the mother to perform relaxation techniques such as deep breathing exercises, guided imagery, meditation, and progressive muscle relaxation.To promote relaxation and reduce stress levels.

Other possible nursing diagnoses:

Nursing References

Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier.  Buy on Amazon

Gulanick, M., & Myers, J. L. (2017). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon

Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2018). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier.  Buy on Amazon

Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier.  Buy on Amazon

Disclaimer:

Please follow your facilities guidelines, policies, and procedures.

The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes.

This information is intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment.

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