At risk Newborn

Question 1

fetal exposure

Answer 1

narcotics and most drugs cross the placental barrier and enter fetal circulation

Question 2

fetal effects related to exposure

Answer 2

IUGR
altered breathing patterns
structural abnormalities
behavioral abnormalities
cognitive impairment
reduced perfusion

Question 3

fetal exposure plan of care

Answer 3

top priority; assess for withdrawal

Question 4

fetal withdrawal

Answer 4

can be asymptomatic at birth
symptoms of withdrawal present within 48-72 hours

Question 5

fetal risks from fetal exposure

Answer 5

IUGR
hypoxic
demise
increased risk for placenta abrupture
structural abnormalities
passive addiction

Question 6

neonatal risks of fetal exposure

Answer 6

withdrawal 24-28 hrs

Question 7

fetal exposure nursing assessment

Answer 7

periodic prenatal toxicology
toxicology on mom in labor
toxicology on baby (urine, meconium, umbilical cord segment)
assess for withdrawal symptoms

Question 8

withdrawal symptoms

Answer 8

hyperactivity
irritable
jittery
exagerrated reflexes
rooting
difficult to console

Question 9

fetal exposure interventions

Answer 9

social services
DCFS
report + toxicology (baby)
assesss s/s of withdrawal
calm environment

Question 10

fetal alcohol syndrome

Answer 10

facial abnormalities - structural
increased cleft
altered birth weight
hearing loss
skeletal/ cardiac abnormalities

Question 11

fetal alcohol syndrome facial abnormalities

Answer 11

small eye openings
thin upper lips
small jaw
wide nasal bridge
indistinct philtrum
epicantal folds

Question 12

withdrawal interventions

Answer 12

calm environment
cluster activities
hand mitts
swaddle hands out
dim lights
check for skin breakdown
rocking baby/ bonding
medicate for seizures (morphine, phenobarbital, methadone)
NO NARCAN