Substance abuse

Question 1

Tendency of those with substance abuse issues

Answer 1

Seeks late prenatal care a lot

Question 2

How to assess for substance abuse

Answer 2

Ask direct, nonjudgemental questions

Question 3

T/F

pregnancy may be a motivator to seek treatmetn

Answer 3

true

Question 4

T/F

Almost all drugs cross the placenta

Answer 4

true

- drugs such as Heparin do not tho bc it is so big

Question 5

What puts baby at risk for intrauterine asphyxia?

Answer 5

Withdrawal from drugs due to mom withdrawing from them

Question 6

Which intrauterine infections are increased risk (related to drugs it think)?

Answer 6

STI’s
HIV
Hepatitis

Question 7

How can alterations in birthweight be related to drugs?

Answer 7

Heroin - low birth weight

Methadone - high birth weight

Question 8

What are Apgar scores like with recent drug use?

Answer 8

Lower due to the asphyxia or drugs given in labor

Question 9

Common complications from drugs

Answer 9

Respiratory distress from meconium

Transient tachypnea from lack of lung fluid clearing depression from narcotic

Jaundice

Congenital anomalies and SIDS (later on)

Growth restrictions over time

Behavioral abnomralities
so not as social, verbal, bad sleepers, attention problems

Question 10

When can see you withdrawal from baby?

Answer 10

24-48 hours but depends on dosage

Question 11

Screening for drug exposure

What is chain of custodies purpose?

Answer 11

1) Meconium (MEC STAT) which collects stool with Chain of Custody COC
2) Urine collection of first stream (pediatric urine collection or bag )
3) Hair samples for long term use
- all of these are COC

COC is for court of law

Question 12

Signs of withdrawal in newborn

General attitude:

Body:

Weird things baby should not be doing at all or in a row :

Answer 12

Hyperactive and irritable

Increased flexion and exaggerate reflexes , tremors

Yawning, sneezing, hiccuping
- if they do this it is a sign they’re in withdrawal

Question 13

What is sleep like in withdrawal baby?

Fever/temp?

Answer 13

Disturbed sleep so short sleep cycles

Low grade fever bc they are alway in motion. Not sick or febrile tho

Question 14

Respiratory pattern in withdrawal baby? What if they’re asleep?

What will their secretions be like?

Answer 14

Greater than 60 so tachypnea
- even when asleep or quiet

a lot of saliva or drooling

Question 15

GI behaviors of withdrawal baby?

Answer 15

Polyphagia
- They act hungry but are poor feeders bc they are uncoordinated and have sensitive gag reflex w nipple.

Diarrhea

Question 16

Vasomotor behaviors of withdrawal baby
natural response

big sign

around mouth

Answer 16

stuffy nose, vomit, sneezing, flushing

sweating; which is not common in baby’s so big sign

Circumoral or around mouth cyanosis

Question 17

Cutenous or skin signs of withdrawal of the baby?

Answer 17

Excoriations on butt, knees, elbows, nose
Facial scratches from hyperactivity
- mittens for face
Pressure injuries like on nose

Question 18

Neonatal abstinence symptoms use?

Answer 18

When you are withdrawing!!!

• can get a score
• you can score them as much as you want
• avg score is 12 for initiation of treatment

Question 19

Treatment for NAS

Answer 19

Oral morphine sulfate
Paregoric gtts
Tincture of opium 
Oral Methadone
Phenobarbital 
Diazepam
Clonidine

• Dose based tho

Question 20

Why do we monitor temp for NAS babies

What else needs to be monitored

Answer 20

We don’t want them in a hyperthermic state

vital signs

Question 21

Why do NAS babies need small frequent feeds

positioning?

Answer 21

They are bad feeders and gag.

put upright

Question 22

How often do we do weights on NAS?

Answer 22

As much as we have to

Question 23

T/F

NAS babies don’t like swaddling

Answer 23

false. well idk they may not but we are supposed to do it

Question 24

How can we protect NAS baby skin from breakdown?

Answer 24

Mittens, sheep skin

Emollients

Question 25

Amount of stimuli allowed for NAS baby?

Answer 25

Low stimuli

Question 26

How long does jittery and irritability last for baby in withdrawal?

Sids death?

Answer 26

Can last past their withdrawal period

• they are difficult to deal with
• often see abuse and neglect

sids death goes up

Question 27

Long term problems

behavior
social
emotions
language 
stimuli
sleep

Answer 27

Increased Behavior problems
Poor social skills
Trouble expressing emotion
Delayed language and motor development
Easily distracted 
Sleep patterns

Question 28

What long term behavior problems could occur from NAS

Answer 28

Increased behavioral problems

Question 29

What are long term social consequences of NAS

Answer 29

Poor social skills

Question 30

What emotion problems could arise from NAS long term wise?

Answer 30

Trouble expressing emotions

Question 31

What developmental issues arise from long term NAS issues?

Answer 31

Delayed language and motor development

Question 32

What attention issues could arise from NAS longterm?

Answer 32

Easily distracted and so inhibited learning

Question 33

What sleep issues could happen due to nAS longterm?

Answer 33

Bad sleep cycles and therefore bad sleep

Question 34

weird card

Answer 34

nothing

Question 35

Why will baby with mom who was NAS or drug abuse have respiratory distress?

Answer 35

BC there is asphyxia and then bc of the stress, meconium is excreted

Question 36

Why does transient tachypnea happen

Answer 36

Bc respiratory depression from narcotics doesn’t allow lung fluid to clear

Question 37

What sort of behavioral abnormalities can arise?

Answer 37

Social, verbal, bad sleep, attention issues