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

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

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

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

5. 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

6. 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

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

8. 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

9. 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 Nov;31(11):
Keegan J, Parva M, Finnegan M, Gerson A, Belden M.Addiction in pregnancy. J Addict Dis Apr;29(2):  

10. Happy! Happy! Happy! ~~~Graduation~~~