11.07 Addicted Newborn

Overview

1. Many drugs cross the placenta and when the infant is born, they are no longer receiving the drug that they have been getting during development, putting them at risk for withdrawal

Nursing Points

General

1. It is important, if possible, to identify the specific drug and the amount to anticipate symptoms and complications, and also to plan the care
2. With increased usage of opioids, more newborns are being born addicted to prescription pain meds in addition to illegal drugs (cocaine, heroin, etc.)
   1. Remember even if they have a prescription doesn’t mean they can’t be born addicted (ie: Oxycodone)
3. Known as neonatal withdrawal, neonatal abstinence syndrome (NAS)

Assessment

1. This is generalized list of the main symptoms and will depend on how the patient is affected
   1. Fever/diaphoresis
   2. High-pitched cry/irritable
   3. Respiratory: Tachypneic/ distress
   4. Gastric issues: diarrhea, vomiting
   5. Sneezing, stuffy nose
   6. Excessive suck, poor feeding
   7. Tremors
   8. Hypertonic

Therapeutic Management

1. This can vary, depending on drug that’s involved
2. Close monitoring and assessment of cardiac, respiratory, neuro systems
   1. Scoring tool (ie: Finnegan)
3. Typically more fussy, they should be held tightly during feedings and other routine care
4. Decrease stimulation as much as possible (quieter isolette area)
5. Swaddle effectively
6. Skin precautions: prevent breakdown from, tremors, loose stools, excessive rubbing or sucking
7. May require smaller, slower feedings or even tube feedings

Nursing Concepts

1. Health promotion
2. Comfort
3. Skin integrity

Patient Education

1. Involve case management to assist mother with resources
2. Scoring tool
3. Here to ensure the safety of her child