150 words initial post
100 words reply post
You are called to a postpartum room and find Michael, a two-hour-old infant, irritable and spitting up copious amounts of formula. You do not know the maternal history, so you advise the mother that you would like to return the baby to the nursery for assessment and monitoring. In the medical record, you focus on the prenatal history and find the mother had an addiction to opioids with her last pregnancy but denied drug use with this pregnancy. You witness the baby having some significant tremors, vital signs: T (axillary) – 36.0, RR- 78, HR- 166, and the infant is alert, irritable, and does not console easily. The infant is constantly moving and sucking vigorously on the pacifier.
What do you think is occurring with the infant?
What lab test can be ordered to confirm your suspected diagnosis?
What interventions can be implemented to treat this infant?
Reply post
Brianna Koren
21 hours ago, at 11:30 AM
NEW
This baby is most likely experiencing neonatal abstinence syndrome, based upon the vital signs that are given. Neonatal abstinence syndrome is a group of conditions caused when a baby withdraws from certain drugs he’s exposed to in the womb before birth. This syndrome is most often caused when a woman takes opioids during pregnancy. “When these drugs are taken during pregnancy, they can pass through the placenta and cause serious problems for the baby” (March of Dimes, n.d.). Symptoms include tremors, overactive reflexes, tachycardia, and fussiness, excessive crying or having a high-pitched cry. Lab tests that can be ordered to confirm a suspected diagnosis of NAS are urine and meconium tests to check for drugs. Meconium is the baby’s first bowel movement. An NAS scoring system is also an option to confirm diagnosis. With this system, the baby’s provider uses points to grade how severe the baby’s withdrawal is (March of Dimes, n.d.). From there, the provider uses the score to decide what kind of treatment the baby needs. The most common treatment option includes taking medicines to treat or manage withdrawal symptoms such as morphine, methadone and buprenorphine. Then, once withdrawal is under control, the baby will start to receive smaller and smaller doses of the medicine over time so their body can adjust to being off the medicine. IV fluids may also be administered, due to the diarrhea and vomiting the newborn may be experiencing from NAS syndrome (March of Dimes, n.d.).