objective 8

Question 1

 Also referred to as Neonatal Abstinence Syndrome (NAS)
 Occurs when fetus has been exposed to opiates in utero
 Opiates cross the placental barrier and affect the fetus
 The baby is born physiologically dependent on the drug
 May suffer withdrawal symptoms after birth

Answer 1

neonatal opioid withdrawal syndrome

Question 2

when are symptoms commonly present?

Answer 2

48-72 hrs post-delivery

Question 3

what are the principal signs of withdrawal?

Answer 3

 High pitched cry
 Body tremors
 Decreased sleep between feeds
 Poor feeding

Question 4

what are the neurological signs?

Answer 4

• Irritability
• Seizures
• Hyperactivity
• High-pitched Cry
• Tremors
• Exaggerated Moro
  Reflex
• Hypertonicity of
  muscles

Question 5

what are the autonomic signs?

Answer 5

• Diaphoresis
• Fever
• Mottled Skin
• Nasal
  Stuffiness
• Tachypnea
  (>60 bpm)

Question 6

what are the GI signs?

Answer 6

• Poor feeding
• Loose stools
• Dehydration
• Vomiting
• Frantic,
  uncontrolled
  sucking

Question 7

what are the miscellaneous signs?

Answer 7

• Disrupted sleep
  pattern
• Excoriations
  (knees, face)
• Temperature
  instability

Question 8

what is the nursing care?

Answer 8

 Encourage skin to skin contact,
swaddling, vertical and slow rocking
 Decrease environmental stimuli- dim
lights, quiet environment, speaking in low
pitch, calm voice
 Encourage breastfeeding as it delays
onset and decreases symptoms of
neonatal withdrawal
 Frequent, smaller feeds are recommended
 May require supplementation to increase
caloric intake or gavage feeding
 If withdrawal symptoms are not well
controlled, then treatment with
medications may be required.
 Rooming- in is encouraged
 Close monitoring of neonate

Question 9

what is the nursing assessment?

Answer 9

 Include questions pertaining to drug use in
pre-natal assessment data collection
 Identify high risk families
 Newborn system evaluation to identify
withdrawal symptoms
 Finnegan Neonatal Abstinence Scoring
system widely used to quantify and
diagnose NAS
 The Finnegan Neonatal Abstinence Scoring
system is a 31-point scale
 The NAS symptoms are weighted numerically
from 1-5 depending on the severity of the
symptom
 Infants scoring an 8 or higher are recommended
for further care like pharmacological therapy
 It is administered every 4 hours