Providing care for the neonate born to a mother who abuses ...

[leilurhhh]

Providing care for the neonate born to a mother who abuses substances can present a challenge for the health care team. Nursing care for this infant requires a multisystem approach. The first step in the provision of this care is
 
  a. Pharmacologic treatment
  b. Reduction of environmental stimuli
  c. Neonatal abstinence syndrome scoring
  d. Adequate nutrition and maintenance of fluid and electrolyte balance

Question 2

A nurse is observing a family. The mother is holding the baby she delivered less than 24 hours ago. Her husband is watching his wife and asking questions about newborn care. The 4-year-old brother is punching his mother on the back.
 
  The nurse should a. Report the incident to the social services department.
  b. Advise the parents that the toddler needs to be reprimanded.
  c. Report to oncoming staff that the mother is probably not a good disciplinarian.
  d. Realize that this is a normal family adjusting to family change.

[Chelseyj.hasty]

Answer to Question 1

C
Feedback
A Pharmacologic treatment is based on the severity of withdrawal symptoms.
Symptoms are determined by using a standard assessment tool. Medications of
choice are morphine, phenobarbital, diazepam, or diluted tincture of opium.
B Swaddling, holding, and reducing environmental stimuli are essential in
providing care to the infant who is experiencing withdrawal. These nursing
interventions are appropriate for the infant who displays central nervous system
disturbances.
C Neonatal abstinence syndrome (NAS) is the term used to describe the cohort of
symptoms associated with drug withdrawal in the neonate. The Neonatal
Abstinence Scoring System evaluates CNS, metabolic, vasomotor, respiratory,
and gastrointestinal disturbances. This evaluation tool enables the care team to
develop an appropriate plan of care. The infant is scored throughout the length of
stay and the treatment plan is adjusted accordingly.
D Poor feeding is one of the GI symptoms common to this patient population. Fluid
and electrolyte balance must be maintained and adequate nutrition provided.
These infants often have a poor suck reflex and may need to be fed via gavage.

Answer to Question 2

D
Feedback
A There is no need to report this one incident.
B Giving advice at this point would make the parents feel inadequate as parents.
C This is normal for an adjusting family.
D The observed behaviors are normal variations of families adjusting to change.

[leilurhhh]

Thank you

[Chelseyj.hasty]

Happy to help you