...neonatal abstinence syndrome causes An infant of a substance-abusing mother (ISAM) is an individual whose mother has taken a substance that may potentially instigate neonatal withdrawal symptoms (1). Prenatal exposure to legal and illegal psychoactive substances can generate physiological and/or neurobehavioral difficulties in the newborn that can initiate complications with feeding, sleeping, movement, and in general poor neonatal adaption process (2). Neonatal Abstinence Syndrome (NAS) refers to the collection clinical signs correlated with opioid withdrawal that usually manifests as neurological excitability, gastrointestinal dysfunction, and autonomic over reactivity (3). Throughout the past decade, there has been rising public health, medical, and political devotion disbursed to the parallel growth in two developments: an escalation in the prevalence of prescription opioid abuse and an escalation in the incidence of NAS. The diagnosis of NAS has increased from 1.20 births 1,000 hospitals births in 2009 to 3.39 births per 1,000 hospitals births in 2009. To put this this number into context, this means 1 infant born every hour the United states had signs of drug withdrawal. Furthermore, maternal substance abuse has increased over the past decade. About 5-10 percent of deliveries nationwide are to women abused substances during pregnancy. The incidence is even higher in inner cities. The two trends are likely intertwined, but many questions remain about the nature of...
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...Neonatal Abstinence Syndrome Neonatal abstinence syndrome (NAS) is a group of complications that occur when a newborn is exposed to addictive drugs while in the mother’s womb. NAS is an increasing problem in the United States that many people are unaware of with a rise of 4.4% in 2013. It is important to understand that NAS not only affects the infant, but it affects the mother as well. Both the infant and mother can develop a wide range of symptoms ranging from mild to severe. Some of these symptoms include neurological, gastrointestinal, and autonomic disorders. Early identification of symptoms is vital to ensure that both the infant and mother receives the best care possible. Another important thing to recognize about NAS is the American...
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...Neonatal Abstinence Syndrome in the Neonatal Intensive Care Unit Neonatal Abstinence Syndrome (NAS) is the withdrawing process that occurs in the postnatal life of newborns after being born to drug addicted mothers. Heroin, codeine, oxycodone, methadone and buprenorphine are opiates and narcotics that are commonly abused throughout pregnancy. Symptoms that an infant may exhibit within the first 24-72 hours of life are: hyperirritability, excessive sucking, inconsolable crying, sweating, diarrhea, sneezing (3-4 times within 30 minutes), tremors/seizures, poor feeding/regurgitation and mottling of the skin. The Association of Women’s Health, Obstetric and Neonatal Nurses, (AWOHNN), convene on an annual basis nationally and provide monthly webinars on various topics. The organization is subcategorized into multiple chapters within each of the 50 states, in which Pennsylvania has six divisions. “Care of Newborns Prenatally Exposed to Opiates” has been a webinar within the last year based on AWOHNN’s webinar calendar. I chose this committee based on their mission statement of improving and promoting the health of women and infants to support the nursing profession through research and education. The name of the journal published by AWOHNN is the Journal of Obstetric, Gynecologic and Neonatal Nursing (JOGNN). My research was done through CINAHL under Drexel’s library resource and by using the keywords of “neonatal abstinence syndrome”...
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...Some drugs are incredibly dangerous for human consumption and use. Such drugs have disastrous effects of people. Sometimes physically, other times, mentally. But the risk for an infant is much higher. In March 3rd 2015, the bill called Protecting Our Infants Act was introduced to the senate. The bill requires the Agency for Healthcare Research and Quality to “report on prenatal opioid abuse and neonatal abstinence syndrome.” The bill also states that programs were to be in place to prevent, identify and treat opioid dependency in women and neonatal abstinence syndrome. Parents and organizations who support children would support the bill because they would want children to be as healthy as they can when they are first born. Reports show that...
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...Perinatal Outcomes: A Meta-analysis Winston-Salem State University A Critique of the Research Article: Methadone/Buprenorphine and Better Maternal/ Perinatal Outcomes: A Meta-analysis Abstract The purpose of this research article is to discuss lower risk drugs such as Methadone and Buprenorphine given to Heroin addicted pregnant patients to create better neonatal and maternal outcomes. This research articles discusses the gold standard of treatment for better neonatal and maternal outcomes. Keywords: heroin, neonatal, maternal, outcomes, methadone, buprenorphine, gold standard treatment A Critique of the Research Article: Methadone/Buprenorphine and Better Maternal/ Perinatal Outcomes: A Meta-analysis Methadone is a synthetic opioid. It is used medically as an analgesic and a maintenance anti-addictive and reductive preparation for use by patients with opioid dependency. It was developed in Germany in 1937. Methadone was introduced into the United States in 1947 by Eli Lilly and Company. The principal effects of methadone maintenance are to relieve narcotic craving, suppress the abstinence syndrome, and block the euphoric effects associated with opiates. When used correctly, Methadone maintenance has been found to be medically safe and non-sedating. It is also indicated for pregnant women addicted to opiates. (doi:http//en.wikipedia.org/wiki/methadone) The theoretical study was not discussed in the articles but Roy’s Model identifies the elements considered...
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...* CHRONOLOGY * * Second Trimester * * Mother attended her community drug and alcohol team (CDAT) were she was on a methadone programme. Referral was made by her key worker stated concerns that she may be pregnant and concealing it * * Pre - birth conference was held to establish the issues surrounding the mother, her pregnancy and her parenting skills. Mother did not attend. The pre – birth conference attended by the CDAT key worker, safeguarding midwife, health visitor, GP, social worker. The pre – birth conference took place as mum was concealing her pregnancy and that she was heavily * * DAY 1 Jack was born by caesarean section because they were concerns with the Zoe. Zoe was unwell – she had a heart valve problem. Jack was admitted to the intensive care unit, needing ventilation support for six hours 12pm * Safeguarding midwife aware that Jack been born, states that all people who needed to be aware of baby being born are. Informed us that her current partner and father of baby are not allowed to visit. Security, front desk at the main entrance of unit and nurses made aware * Urine virology/toxicology sent * Morphine started as Jack was Ventilated due to the respiratory distress 15pm * Out of hours social worker called inquiring about baby and mum 1630pm * Maternity support worker visited unit, updated on baby’s condition. Mum had her surgery – she will go and update mum 1830pm * Nurse looking after mum on...
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...prescription drug abuse increases, doctors face many challenges dealing with pregnant women giving birth to newborns addicted to opiates . While many people start out with narcotic pain killers prescribed by a doctor, they become habit-forming and can lead to a road of addiction and destruction in one’s lives. “These infants experience what's called neonatal abstinence syndrome as they undergo withdrawal from the addictive drugs their mothers took during pregnancy. Most often these are narcotic painkillers, such as oxycodone, morphine or hydrocodone, according to the report from the U.S. Centers for Disease Control and Prevention.” (Reinberg, 2015, p.1) Doctors could be somewhat unsure on exactly what to do, from sedating the newly born babies with withdrawal medications to any type of prescription medications, it brings a high risk to the life of the new born. Diagnosing the mother and infant with treatments provided by doctors will insure their survival and help them to live a healthy life. The problems that occur in a newborn who was exposed to addictive illegal or prescription drugs while in the mother’s womb, known as neonatal abstinence syndrome (NAS) include two major types of NAS: NAS due to prenatal or maternal use of substances that result in withdrawal symptoms in the newborn and postnatal NAS secondary to discontinuation of medications such as fentanyl or morphine used for pain therapy in the newborn. (Hamdan, 2014) “According to researcher Jennifer Lind, a CDC epidemiologist...
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...Affected by Heroin Abuse Christina Anderson Cochise College Lisa Benson February 16, 2011 Evidence Based Practice: Nursing Care of Infants Affected by Heroin Abuse According to Wang (2010), the prevalence of prenatally exposed newborns to one or more illicit drugs averages approximately 5.5 percent. Substance abuse during pregnancy can negatively affect the fetus and neonate. According to the National Drug Intelligence Center (n.d.), heroin is a highly addictive and rapidly acting opiate that is produced from morphine. According to Murray & McKinney (2010), the signs and symptoms observed in the neonate will be different depending on the type of drug used by the mother, but common signs seen in a neonate experiencing neonatal abstinence syndrome include: irritability, jitteriness, diarrhea, frequent regurgitation, and tachypnea. In cases where heroin is used, these signs and symptoms most commonly become apparent 1 and 144 hours after birth, and may last from 7 to 20 days (Cloherty, Eichenwald, & Stark, 2008). Nursing Diagnosis An appropriate nursing diagnosis for an infant experiencing withdrawal from heroin would be disturbed sensory perception related to altered sensory reception as manifested by irritability, jitteriness, and restlessness (Ackley & Ladwig, 2008; Cloherty, et al., 2008). This disturbed sensory perception could exacerbate the infant’s already increased heart rate, respiratory rate, and fluid loss due to regurgitation. It is important to calm to soothe...
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...Kaisha Killion Professor Salmond Developmental Psychology 27 Sept. 2013 Substance Abuse and Pregnancy Women are incredible creatures. Women have the incredible ability to aid in the development of a new life within a matter of months. Whether a pregnancy is wanted or unplanned the process of development for the young zygote nestled within the mother’s womb is still phenomenal. The developing bundles of cells are very vulnerable from the very start to the end of a pregnancy. The progress of development for the zygote is a delicate one than can be interrupted or slowed down by many internal and external forces. The forces that can interrupt development can range from biological to environmental. The woman carrying the child is responsible for not only her life but the life of her unborn child. Many activities a mother engages in, the unborn child engages in as well. Activities that the mother participates in can be harmless such as listening to music or enjoying a healthy snack. Unfortunately, some activities are not beneficial for the new life. A mother who participates in substance abuse is putting herself and her child at risk. Substance abuse during pregnancy can have adverse effects on the mother, the unborn child, and raises an ethical dilemma. The online Merriam Webster dictionary states that “Autonomy is self-directing freedom and especially moral independence” (Merriam-Webster). Autonomy is a freedom that many individuals can exercise but it takes...
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...Monique Hidalgo, an incarcerated mother who got taken the right away to breastfeed while in prison, fought for her fundamental rights for the personal care she wanted for her child. This thirty-three-year-old woman believed that all women should be handed the right to breastfeed their child if they wish to, even if they were behind bars. She was taken the right away because those are the prison rules, but she did not accept the fact that she could not provide the sufficient needs for her baby. The criminal justice stated that most needs are obligated to men, since there used to be a low percentage of incarcerated women. However, the percentage of women being incarcerated has been increasing for a couple of years...
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...or developing, consider teenage pregnancy a social taboo and this stigma can have negative effects the teenager's self-esteem and actualization. An example would be in certain African societies when a girl is found to be pregnant out of wedlock she is immediately labelled as damaged goods and most of the time she is subjected to abuse from the community and family this threatens the safety of herself and the child. However in the western countries most of the time for the teen moms to be able to cope with the stress of raising a child and the ongoing negativity surrounding them, most of them turn to drugs to cope. This will eventually lead to many addiction issues for the mother and the child might be born with a syndrome known as Neonatal Abstinence Syndrome that occurs when a baby is exposed to drugs in the womb before birth and goes through drug withdrawal after birth and as the child grows he/she might follow the same vicious cycle of...
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...A reflection on the ethical and morally challenging issues surrounding the scenario and concept will conclude. Patient Encounter A few incidences of abuse in the health care setting have been personally witnessed, both nurse to patient abuse and patient to nurse abuse, but it feels as though the situation chosen to explore in depth struck me on a deeper level. The situation consisted of a more subtle form of abuse seen in healthcare often overlooked; the abuse observed by nurses in the Neonatal Intensive Care Unit. As the writer entered the maternity floor, it was an incredible shift from a miserable floor to an environment filled with joy and happiness. While orienting to the unit, the most adorable newborn babies were seen left, right and center, especially as the doors were opened to the NICU. Both areas of the NICU were offered to explore, and even interact with some of the babies. The writer saw some extremely critically ill newborns, and some newborns that just needed some love and attention in order to go home. What stood out the most was how tiny some of these newborns were – one was the size of the average hand palm,...
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...Research Critique of a Quantitative Study The purpose of this research critique is to inform the reader of a randomized clinical study regarding the treatment of Neonatal Abstinence Syndrome (NAS). This writer is interested in the treatment of drug exposed infants and the goals of reducing babies’ hospitalization in the Neonatal Intensive Care Unit (NICU). The study researches the adjunct therapy for treatment of NAS. The study will be broken down into the following units: protection of human participants, type of data collection utilized in the study, data management and analysis, findings and interpretation of these findings and finally the conclusion of the study and its findings. Protection of Human Participants This study’s goal is to differentiate the efficacy of clonidine versus phenobarbital in adjunct therapy with morphine sulfate in the treatment of NAS. One of the benefits of this study is the importance of standardization of a weaning protocol. The weaning protocol did not change from day to day and provider to provider as can be the case outside of the study. Another benefit is the predefined measures for each study group that were considered adverse events. These measures worked as a safety net to ensure the study was done safely and not causing harm to the babies. One noted concern/risk noted by the author was the potential for prolonged exposure to phenobarbital on a baby’s developing brain. The concern is the phenobarbital may cause behavioral compromises...
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...what the attraction is to the people who get themselves addicted to drugs is? A lot of people have done research to try and figure out what causes people to become addicted to drugs. Most people doing the research have failed in finding any true research to what causes people to become addicted to drugs. There are some drugs that people need to take, but the effects of other drugs is something people do not think about. There are people who are pregnant and do not realize that they are not only harming themselves but their newborn child. The problems that could happen are Alcoholic Fetal Syndrome (AFS). This is where the child is already born addicted to alcohol. When a child is born with the drugs in their systems, doctors will give them opiates. They are drugs to help the children deal with their addictions. When children are born with such addictions it is called Neonatal Abstinence Syndrome (NAS). Babies born with addictions have soared from 354 to a whopping 1,374 in 2010, that is a jump of 1,020 in just four years....
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...accidents. They argue with the family members all the time, because they cause problem for the family members due to their addiction. They scream loudly, break things, walls and furniture, they might say or do wrong things that upset neighbors and friends and make the family members ashamed. When parents or other family member abuses drugs, the children in that family get hurt. The parents are unable to take care of their children. The home become unsafe for those children. The people who are addicted they don’t think they are sick or, they need treatment. They don’t realize that they are causing trouble for the other family members. When a pregnant woman abuse heroin or any prescription opioids can cause withdrawal syndrome called Neonatal Abstinence Syndrome (NAS) in her infant. Second hand tobacco smoke is an environmental hazard, which can affect the non-smokers by increasing their risk of heart disease and lung cancer. Close family members become codependent to maintain relationship. They have strict rules. They don’t talk, don’t feel, don’t trust, don’t lose control, and don’t seek any help from outside. They suffer from emotional stress, ulcers, skin disorders, migraine headache, chronic colds, and backaches. 4. Suggest important supports/resources for the group (available or should be available): Primary, secondary, tertiary. The Primary prevention of ATOD problems includes education about drugs and guidelines for their use. Nurses can provide community education...
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