Module 05: Pre-gestational Problems: Substance Abuse Flashcards
Why do women with pre-gestational problems need counseling before pregnancy?
To identify early interventions and prevent adverse effects on both the mother and baby.
It is dependence on substances that negatively affect work, health, and social relationships. It is common in women of childbearing age.
SUBSTANCE ABUSE
What is the most commonly abused substance during pregnancy?
Alcohol, a CNS depressant that is easily accessible and a potent teratogen.
What age group has the highest incidence of alcohol abuse in women?
Women ages 20 to 40 years old (CHILDBEARING AGE).
How does alcohol abuse affect the mother during pregnancy?
(A) Malnutrition (Folic acid & thiamine deficiency → neural tube defects)
(B) Bone marrow suppression
(C) Increased risk of infections
(D) Liver disease
Why is alcohol abuse particularly dangerous in the first trimester of pregnancy?
It affects organogenesis, leading to nutrient deficiencies and permanent neurologic damage to the fetus.
A permanent condition caused by alcohol exposure during pregnancy, affecting the growth and development of the fetus.
Fetal Alcohol Syndrome (FAS)
How does alcohol affect the fetus physically and mentally?
(A) Physical and mental abnormalities
(B) Oxygen utilization impairment
(C) Intoxication of the infant (Fetal Alcohol Effects)
(D) Inhibition of maternal letdown reflex
(E) Mental retardation
(F) Intrauterine Growth Restriction (IUGR)
What are the common facial deformities seen in babies with Fetal Alcohol Syndrome?
(A) Small eyes
(B) Low nasal bridge
(C) Flat mid-face
(D) No cupid’s bow
(E) Thin upper lips
What does TACE assessment stand for in screening alcohol dependence during pregnancy?
(A) Tolerance
(B) Annoyed
(C) Cut down
(D) Eye opener
How does alcoholism result in physical and mental abnormalities?
Alcohol in the blood of the mother moves into the fetus through placental transfusion, making it concentrated. This often hinders the child’s ability to utilize oxygen properly
Nursing Care for Pregnant Women with Alcohol Dependence
(A) Sedation (if needed) – Oral benzodiazepines (lorazepam, diazepam)
(B) Seizure precautions
(C) IV fluid therapy
(D) Discourage breastfeeding (to prevent fetal intoxication and inhibition of the letdown reflex)
(E) Screen, identify, and offer psychosocial support
Why should benzodiazepines be used with caution in pregnant women?
Due to limited clinical data on safety and potential neonatal withdrawal effects.
This substance acts at the nerve terminals. It is often absorbed in the mucus membranes and effects the CNS, which results into vasoconstriction, tachycardia, high blood glucose levels, and hypertension.
Cocaine
How does cocaine affect the central nervous system (CNS)?
It prevents reuptake of dopamine and norepinephrine, leading to high catecholamine levels and a state of euphoria lasting about 30 minutes.
How long can cocaine metabolites be detected in urine?
4 to 7 days after use.
What are the withdrawal symptoms of cocaine?
(A) Depression
(B) Irritability
(C) Nausea
(D) Lack of motivation
(E) Psychomotor changes
What are the different signs of use of cocaine?
(A) Mood swings
(B) Appetite changes
(C) Withdrawal Symptoms
What are the different effects of cocaine on the mother? (SPCRHSAPS)
It is dangerous because of vasoconstriction, which could potentially impact placental circulation.
(A) Seizures and Hallucinations
(B) Pulmonary edema
(C) Cerebral hemorrhage
(D) Respiratory failure
(E) Heart problems
(F) Spontaneous Abortion
(G) Abruption placenta
(H) Preterm birth
(I) Stillbirth
What are the different effects of cocaine on the fetus? (ISCASMAI)
(A) IUGR (Infrauterine growth restriction)
(B) Small head circumference
(C) Cerebral infarction
(D) Altered brain development
(E) Shorter body length
(F) Malformations of the genitourinary tract
(G) Apgar score (low or poor)
(H) Intercranial hemorrhage (tremors, muscle rigidity and irritability)
What nursing intervention helps cocaine-using mothers care for their infants?
(A) Anticipatory guidance on interpreting feeding cues
(B) Restricting mother-infant bonding
(C) Encouraging formula feeding only
What plant is marijuana obtained from?
Hemp plant (Cannabis).
Does marijuana have a teratogenic effect on the fetus?
No, there is no evidence that it has a teratogenic effect.
What is the full name of MDMA?
Methylenedioxymethamphetamine (Third most widely used illicit drug).
How is MDMA commonly taken, and how long do its effects last?
It is taken in tablet form, and its effects last for about 4 to 6 hours.
What are the common signs and symptoms of MDMA use?
Euphoria, feeling of empathy (hug drug).
What are the adverse effects of MDMA?
Clouded thinking, agitation, disturbed behavior, sweating, dry mouth, tachycardia, muscle spasms, jaw clenching, and hyperthermia.
How does the duration of MDMA’s effects compare to cocaine?
The effects of MDMA last longer than cocaine.
What cognitive issue is associated with MDMA use?
Impaired memory and learning difficulties in children.
What type of drug is heroin?
A CNS depressant narcotic.
What effects does heroin produce?
Intravenously (shooting), intradermally (skin popping), or inhalation (snorting).
What are the effects of heroin on the mother?
(A) Increased incidence of poor nutrition, iron deficiency anemia, and pre-eclampsia
(B) Gestational hypertension
(C) Phlebitis, subacute bacterial endocarditis
(D) Hepatitis B infection
(E) HIV Infection
What are the effects of heroin on the fetus?
(A) Increase risk for IUGR
(B) Meconium aspiration
(C) Hypoxia
(D) Fetal opiate dependence (high pitched cry, irritability, fist sucking, vomiting and even seizures can occur)
(E) Severe abstinence symptoms after birth
(F) SGA
(G) Fetal Distress
What is methadone commonly used for?
It is used for women dependent on opioids.
How does methadone help opioid-dependent individuals?
It blocks withdrawal symptoms and reduces or eliminates the craving for narcotics.
What are the effects of methadone on the mother?
(A) Pre-eclampsia
(B) Placental problems
(C) Fetal malpresentation
What are the effects of methadone on the fetus?
(A) Reduced head circumference
(B) Low birth weight
(C) Newborn - experiences withdrawal symptoms that are severe and lasting longer
What are the different types of nursing diagnosis under substance abuse?
(A) Imbalanced Nutrition: Less than Body Requirements related to inadequate food intake secondary to substance abuse.
(B) Risk for Infection related to use of inadequately clean syringes and needles secondary to IV drug use
(C) Risk for ineffective Health Maintenance related to a lack of information about the impact of substance abuse on the fetus
What are the different approaches in planning and implementation under substance abuse?
(A) Prevention of substance abuse during pregnancy is the ideal nursing goal and is best accomplished through education
(B) Provide information about the relationship between substance abuse and existing health problems and the implications for the woman’s unborn child
(C) Preparation for labor and birth should be part of prenatal planning
(D) Preferred methods of pain relief include the use of psycho-prophylaxis and regional blocks (epidurals) or local anesthetics (pudendal block, local infiltration)
What are the different approaches of evaluation under substance abuse?
(A) The woman is able to describe the impact of her substance abuse on herself and her unborn child
(B) The woman gives birth to a healthy infant
(C) The woman accepts referral to social services for follow-up care after discharge
