While abuse of alcohol, marijuana and heroin has remained relatively stable, cocaine and crack cocaine use is dramatic, approximately 1 in 10 pregnancies (higher in urban areas). Besides alcohol and drugs, prescription drugs are used, and the use of multiple substances is common. 80% -90% of babies born addicted mothers are physiologically dependent and experiences outward signs of withdrawal are often called neonatal abstinence syndrome or neonatal abstinence syndrome. It is estimated that only cocaine effects from 30.000 to 50.000 children born each year. Moreover 3000-5000 children each year, states that suffer from FAS. The care plan should be used in conjunction with the previous newborn plans of care. Contact CPS: Baby premature and abnormal growth patterns, as appropriate.
Neonatal EVALUATION DATABASE
The severity and duration of symptoms associated with the substance (s) abused, duration of treatment and the parent drug levels at birth.
Activity/Rest
High-pitched crying, alertness, short, restless sleep, yawn
Problems with the maintenance of anxiety
Circulation
Tachycardia
Hypertension
Ego Integrity
Poor conditions Organization (cocaine)
Elimination
Diarrhea
Hyperactive bowel sounds (hypermotility)
Food / Fluid
You can increase or LBW infants, perhaps IUGR (mother of heroin, cocaine or alcohol or malnutrition in children), or can higher-birth-weight/LGA child (mother, methadone) is
Poor nutrition of wild uncoordinated sucking, gluttony, dripping, hiccups, possible cleft lip
Weight loss or weight gain immediately
Vomiting
Dry mucous membranes, poor skin turgor, sank fontanelles
Bloating, changes in bowel sounds, increased bowel (paralytic ileus, NEC)
Sensorineural
Apgar score may be low (eg, intrauterine asphyxia or drug given to mothers during delivery period).
Small head circumference / SBA (nicotine), microcephaly (FAS toxic gas cocaine abuse), vision impairment (FAS toxic gases abuse).
Hyperirritability (including increased fear response), hyperactivity, poor organization, there may be hypertonicity.
Hyperacusis (abnormal sensitivity to sound) or problems with attention, are actively involved in auditory and visual stimuli.
Tremor, persistent or rhythmic twitching or myoclonic seizure activity noted.
Increase or exaggerated reflexes (eg, gag, suck, root, deep tendon reflexes and Moro), may be regarded as weak or absent reflexes, poor muscle tone / Emergency (perinatal stroke).
Extended / iris vessels.
Breathing
Periods of apnea (cocaine), transient tachypnea (heroin).
Increased tearing, runny nose, stuffy nose, sneezing or yawning may be present.
Signs of respiratory distress, green-tinged mucus (meconium aspiration) (heroin).
Tracheoepiglottal anomalies (FAS).
Security
Temperature Changes.
Sweet spots, rinse and can be seen.
Rub marks on the face and knees, associated with permanent "mouthing / crawling" movement venous pressure point.
Sclera, the skin may be biased.
Congenital abnormalities (associated with cardiovascular or the genitourinary system) may be present.
Signs of infection or sepsis (uterus), history of premature rupture of membranes, abnormal immunological mechanisms (marijuana).
Social interaction
They have poor tolerance to be used, which the interactive behavior (problems in response to human voice and face of the impacts on the environment), aversion to view.
Sexuality
Women are more affected by the ratio of 2:1 (FAS)
Genital disease in women (FAS)
Education and training
It may be premature.
The mother may have received no prenatal care (literature shows that 75% of women who abuse drugs during pregnancy to seek prenatal care until the onset of labor) or take the problems of premature birth, birth, abruptio placenta or placenta previa (placental insufficiency / fetal asphxia), infections such as pneumonia, endocarditis, STDs, or hepatitis, anemia and PIH.
Diagnostic tests
Toxicology Drug Screen (mother / child blood and urine and fetal meconium) for current exposure to dust. Cocaine metabolites in urine may continue for 4-7 days after use, or more children.
Electrolyte levels: vomiting / diarrhea lead to disruption of electrolyte balance.
Glucose levels: they can be reduced (increased metabolism, poor nutrition, limited food supply [FAS]).
CBCD and blood culture: the differential diagnosis of sepsis. IMS is still one of the most insidious and deadly infection in the newborn.
Platelets: Can be reduced (sedatives or infectious processes).
Serology: determining the presence of sexually transmitted diseases such as syphilis, hepatitis B and AIDS.
Serum bilirubin: increased risk of hepatitis (particularly children methadone users).
Electro-encephalogram (EEG) is an unusual disorder in the brains of cocaine-exposed children. Normalization of the EEC observed 3.12 p age.
LP: Determination of white blood cells and bacteria-specific antigens of GBS.
Nurses PRIORITIES
Facilitate and support the first introduction of food.
Second detection of infectious process.
3rd To avoid injury, and the risk of short-and long-term complications.
4th Adoptive parent-child interaction and affection.
5th Provides information and support to parents (s) during the rehabilitation process.
Exemption OBJECTIVES
Weight it first.
2nd No injuries, complications resolved.
Third mother-child interaction is progressing satisfactorily.
4th Parents (s) / guardian understand the current status of the prognosis of the child, and needs.
Parents fifth (s) / guardian participation in the care and available resources.
6th Action Plan for the daily needs after discharge.
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