Providing care for the neonate born to a mother who abuses substances can present a challenge for the health care team. Nursing care for this infant requires a multisystem ap-proach. The first step in the provision of this care is:
a. Pharmacologic treatment.
b. Reduction of environmental stimuli.
c. Neonatal abstinence syndrome scoring.
d. Adequate nutrition and maintenance of fluid and electrolyte balance.
C
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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.
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