Maternal Analysis|Course hero helper

Posted: January 30th, 2023

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?

SOLUTION

The infant appears to have symptoms consistent with neonatal abstinence syndrome (NAS), which occurs when an infant is exposed to addictive substances in utero and experiences withdrawal symptoms after birth.
To confirm the suspected diagnosis, a urine toxicology screen can be ordered.

The infant may be experiencing neonatal abstinence syndrome (NAS) due to opioid exposure in utero.
The lab test that can confirm this suspected diagnosis is a meconium or umbilical cord drug screen.
Interventions to treat the infant with NAS can include pharmacologic management with morphine or methadone, non-pharmacologic management such as swaddling, holding, and providing a calming environment, and close monitoring of symptoms and vital signs.