Neonatal Abstinence Syndrome – A case study JenRenee Paulson, UW School of Nursing 5/31/14

Patient - Opi DOL 13 2900g Term 6lbs 4 oz

Pt Hx Mother - methamphetamines and tobacco. Opi – CPS involved Living situation stable 2 children state custody Opi – CPS involved

Opi’s Assessment VS stable Signs: Hypertonia Yawning Emesis Excessive suck Sneezing Diaphoresis Diarrhea Failure to gain wt

signs/symptoms of NAS Neonatal Abstinence Scoring Sheet W ithdrawal I rritability T remors H yperactive, High-pitched cry, Hypotonia D iarrhea, Disorganized suck R espiratory distress, Rhinorrhea A pneic attacks W eight loss A lkalosis – respiratory L acrimation

Treatment IV Methadone – D/cd at 12 days VS q15min until stable (respiration) I/Os Small frequent meals – emesis, diarrhea. Swaddling - hands for self-soothing Mittens for scratching Quiet/calm atmosphere

Failure to gain wt. Loss of weight Back to higher calorie formula

Other considerations: Risk for infection r/t maternal drug use Risk for impaired physical or cognitive development r/t inefficient maternal nutrition Interrupted family process r/t lack of permanent placement

References Ackley, B. J. (2010). Nursing diagnosis handbook: an evidence-based guide to planning care (9th ed.). Maryland Heights, Mo.: Mosby. Davidson, M. R., & London, M. L. (2012). Olds' maternal-newborn nursing & women's health across the lifespan (9th ed.). Boston: Pearson. Bio LL, Siu A, Poon CY. Update on the pharmacologic management of neonatal abstinence syndrome. J Perinatol. 2011 Nov;31(11):692-701 Keegan J, Parva M, Finnegan M, Gerson A, Belden M.Addiction in pregnancy. J Addict Dis. 2010 Apr;29(2):175-91. 

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