Author Question: A pregnant patient in active labor is admitted to the emergency department. A toxicology screen and ... (Read 116 times)

NguyenJ · **on:** Jul 23, 2018

A pregnant patient in active labor is admitted to the emergency department. A toxicology screen and a physical assessment reveal that the patient is an active heroin addict.

The nurse who cares for the neonate after delivery should anticipate which clinical manifestation(s)?
a. Passivity and flat affect
b. Diarrhea and salivation
c. A shrill cry and irritability
d. Continuous restless sleep

Question 2

A nurse is caring for a patient and her newborn immediately after delivery.

The patient's medication history includes prenatal vitamins throughout pregnancy, one or two glasses of wine before knowing she was pregnant, occasional use of an albuterol inhaler in her last trimester, and intravenous morphine during labor. What will the nurse expect to do?
a. Administer opioids to the infant to prevent withdrawal syndrome.
b. Monitor the infant's respirations closely and prepare to administer oxygen.
c. Note a high-pitched cry and irritability in the infant.
d. Prepare the patient for motor delays in the infant caused by the alcohol use.

Sierray · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: C
The newborn of an active heroin addict experiences a withdrawal syndrome that includes shrill crying, vomiting, and extreme irritability. The newborn will not experience passivity or a flat affect, diarrhea or salivation, or continuous restless sleep as a result of being born to an active heroin addict.

Answer to Question 2

ANS: B
Narcotics given for pain during labor cross the placenta and can cause respiratory depression in the infant. Nurses must be prepared to provide respiratory support and to give naloxone to reverse the narcotic effects if necessary. Exposure to opioids during labor is not sufficient to cause dependence, so withdrawal syndrome is not an issue. Infants withdrawing from drugs have a high-pitched cry and are irritable, which is not expected in this case. Any drug taken during the first weeks of pregnancy tends to have an all or none effect, meaning that they either cause death of the conceptus or, if sublethal, the conceptus recovers.