The nurse is caring for a 1-day-old client at term gestation who is irritable, feeding poorly, and only sleeping for very short intervals. The newborn's mother informs the nurse that she has been taking hydrocodone on a regular basis for several years. Which intervention is appropriate to include in the newborn's plan of care?

Question

The nurse is caring for a 1-day-old client at term gestation who is irritable, feeding poorly, and only sleeping for very short intervals.  The newborn's mother informs the nurse that she has been taking hydrocodone on a regular basis for several years.  Which intervention is appropriate to include in the newborn's plan of care?

Quizplus · Accepted Answer

11ecbb05_cc1d_5ed8_b433_d38631d0279a_MD0009_00 The newborn of a mother who is opioid-dependent (eg, heroin, methadone, hydrocodone) is at high risk for neonatal abstinence syndrome (NAS) or drug withdrawal secondary to in utero exposure to maternal substance abuse. Opioid withdrawal typically manifests within 24-48 hours after birth. Clinical manifestations of withdrawal include irritability, jitteriness, high-pitched cry, sneezing, diarrhea, vomiting, and poor feeding. The newborn with NAS is at risk for skin excoriation from excessive movement caused by hyperactivity and restlessness. The nurse should swaddle the newborn with the arms and legs flexed to prevent skin damage from excessive movement and minimize stimulation. If signs of overstimulation (eg, sneezing, arching) continue, then gentle, rhythmic rocking may soothe the newborn (Option D). (Option A) Ineffective, unorganized sucking patterns are common in newborns with NAS. Between feedings, a pacifier may soothe the newborn and help establish an organized sucking pattern. (Option B) Regurgitation is common in newborns with NAS. The parent should hold the newborn upright shortly after feeding to reduce the risk of vomiting and aspiration. (Option C) The nurse should place the newborn in a quiet, dimly lit area and organize tasks to minimize stimulation (eg, cluster care). Educational objective: The newborn of a mother who is opioid-dependent is at high risk for neonatal abstinence syndrome. Swaddling and gentle, rhythmic rocking can soothe the newborn, minimize stimulation, and prevent skin excoriation from excessive movement caused by hyperactivity and restlessness.

The Nurse Is Caring for a 1-Day-Old Client at Term