Prenatal
When is a fetus the most at risk for harm due to substance abuse?
The first trimester, this is when the major organ systems and body structures are developing and substance abuse can cause significant damage to development
It is __ to __ times greater risk of a stillbirth from substance use in pregnancy
2 to 3
List a few symptoms of withdrawal in newborns
tremors, excessive crying, hyperactive reflexes, restlessness, tight muscle tone
A nurse is caring for a client who is withdrawing from cocaine. Which symptoms should the nurse expect?
A. Hypertension and hallucinations
B. Euphoria and insomnia
C. Fatigue and depression
D. Dilated pupils and tachycardia
Ans. C
Rationale: Cocaine withdrawal is typically characterized by fatigue, depression, and increased appetite.
This screening technique uses nonjudgmental questions to assess for substance use during prenatal visits.
What is SBIRT (Screening, Brief Intervention, and Referral to Treatment)?
SBIRT is an evidence-based model for identifying and helping patients with substance use.
What are the most commonly abused substances during pregnancy?
Alcohol is the #1 most common substance abused during pregnancy, along with tobacco, opioids, nonprescription drugs, and marijuana
what is a quick assessment of a baby's health at birth and why is it so important during substance abuse?
APGAR score
it can be low APGAR scores and may need interventions
What are the long-term effects of withdrawal in a baby?
impaired growth, altered brain development, birth defects, behavior problems, short-term memory loss, cognitive and social defecates.
Which intervention is appropriate for a newborn with neonatal abstinence syndrome (NAS)?
A. Provide frequent stimulation with bright lights and noise
B. Administer glucose water for irritability
C. Swaddle the infant and reduce environment stimuli
D. Limit feeding to every 6 hours.
Ans. C
Rationale: Infants with NAS are hyperirritable and benefit from calming environments, gently handling, and swaddling to decrease stimulation and promote comforting.
Nurses should teach pregnant women that stopping substance use abruptly without medical supervision may lead to:
What is miscarriage, preterm labor, or fetal distress?
Withdrawal can cause serious complications for the fetus if not medically managed.
What are some positive outcomes and goals for substance abusers prenatally?
-routine prenatal care
- avoiding and/or reducing substances they are using
-patient can describe the impact and harm that substances have on the baby and herself
- giving birth to a healthy newborn
-going to follow ups after delivery
What is the most common complication related to substance abuse that a baby can go through upon birth?
Neonatal Abstinence syndrome (NAS)
What nursing interventions should be performed when signs of newborn withdrawal are present?
Low-stimulating environment, skin to skin, rocking baby (gives sense of security), encourage parents to participate with newborn care, provide resources for addicted parent(s), frequent feedings, monitoring vital signs, use facility tools to determine severity of withdrawal and treatment decisions.
A nurse is caring for a pregnant client with a history of heroin used. Which of the following medications should the nurse anticipate being prescribed to reduce withdrawal symptoms?
A. Methadone
B. Naloxone
C. Diazepam
D. Disulfiram
Ans. A
Rationale: Methadone is a long-acting opioid agonist used to manage withdrawal symptoms in opioid dependent pregnant women. It helps prevent fetal withdrawal and supports maternal stabilization
A newborn’s high-pitched cry, poor feeding, and tremors should prompt the nurse to assess for this.
What is neonatal abstinence syndrome (NAS)?
These are classic signs of opioid withdrawal in a newborn.
A nurse is assessing a postpartum woman who appears anxious and reports difficulty sleeping. She has a history of alcohol use, which action should the nurse take first?
Screen for alcohol withdrawal symptoms
A postpartum woman expresses feelings of guilt about her past substance use during pregnancy. What is the most appropriate nursing response?
A) "you should focus on staying clean now"
B) "many mothers feel this way, its part of the process"
C) "lets talk about these feelings and how we can support"
D) "Don't worry, your baby is healthy now"
Answer C
A nurse is planning care for a postpartum woman with a history of substance abuse, which intervention is most important to include?
A) Encourage participation in parenting classes
B) schedule regular follow up appointments
C) provide information on nutrition and exercise
D) discuss contraception options
Answer: B