Answer to Question 1
2
Rationale:
1. The gravida who has intrauterine growth problems might be compromised due to placental insufficiency.
2. The biophysical profile is used when there is a risk of placental and/or fetal compromise. The gravida with mild hypertension will need to be monitored more closely throughout the pregnancy, but is not a candidate at present for a biophysical profile.
3. The gravida who is post-term might be compromised due to placental insufficiency.
4. The gravida who is experiencing decreased fetal movement for 2 days needs assessment of the placenta and the fetus.
Answer to Question 2
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 provid-ing care to the infant who is experiencing withdrawal. These nursing interven-tions are appropriate for the infant who displays central nervous system (CNS) 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 Absti-nence Scoring System evaluates CNS, metabolic, vasomotor, respiratory, and gastrointestinal disturbances. This evaluation tool enables the care team to de-velop 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 gastrointestinal symptoms common to this patient population. Fluid and electrolyte balance must be maintained, and adequate nu-trition provided. These infants often have a poor suck reflex and may need to be fed via gavage.