"Neonatal Abstinence Syndrome" is a wonderful example of a paper on child development. This paper discusses the appropriate nursing care of a 6 weeks old infant under my care as a nurse, admitted to the hospital with the diagnosis of vomiting, dehydration with a health history of substance abuse (the mother was on methadone during pregnancy), the newborn baby is placed on methadone as well. Introduction When managing patients, nurses need to prioritize their nursing diagnosis and the interventions they give to their clients. To be precise, they need to give individualized care to clients and use the nursing care plan as a tool in client management.
In our scenario the infant presents with dehydration and vomiting, which are some of the symptoms found in Neonatal Abstinence Syndrome (NAS): also known as passive addiction, it is a syndrome of drug withdrawal observed in infants of mothers physically dependent on drugs. It results from exposure in the uterus or postnatal exposure to illicit drugs or aids (Sublett, 2013). “ The American Academy of Pediatrics reported that 50 to 95 percent of infants exposed to opiates or its derivatives, including heroin and methadone, develop NAS” (Katherine, 2012). Diagnosis of NAS: the diagnosis is based on the maternal history of drug and substance abuse during pregnancy and symptoms presented by the infant which in our case may be; history or actual diagnosis of vomiting and diarrhea, sleeping difficulties, irritability, tremors, feeding difficulties, tense arms, legs and back, high pitched cry and long hospital stay (Williamson, 2013). Infants with NAS require non-pharmacological therapy in addition to medical treatment; this involves supportive care for the infant (Sublett, 2013).
In our case, the infant presents with an actual diagnosis of vomiting/dehydration. Wachman, et al (2010), says that breastfeeding is not contraindicated in infants with NAS. If a mother is on buprenorphine or methadone, these medications can still be taken while breastfeeding. He further says that breastfeeding is beneficial for the infant and the mother, despite the opiate addiction (Sublett, 2013). It also aids in bonding, it’ s the best way to reduce dehydration as milk has enough water to rehydrate the infant. Incase vomiting persists ant-emetics may be administered intravenously and small amounts of breast milk given at intervals. Pharmacological interventions are commonly used as a treatment for NAS; however, their safety and effectiveness are not completely documented.
Pharmacological treatments for NAS include medications such as Phenobarbital, morphine, methadone, and buprenorphine (Sublett, 2013). Medical treatment of the NAS: continue administering methadone as prescribed by the physician. Always administer the drug before feeding if the vomiting persists, this will prevent the infant from vomiting the drug. I have learned that non-pharmacological therapy is of equal importance in the management of Neonatal Abstinence Syndrome.
Mothers may continue to breastfeed as breast milk is beneficial to both the infant and the mother; in addition, breast milk may reduce the length of hospital stay for the infant, as they can be more easily weaned from breast milk than opiate itself (Sublett, 2013). Conclusion Better management of NAS is hindered by the current lack of evidence-based guiding principles and protocols for pharmacological and non-pharmacological management and care that promote improved outcomes for NAS patients. Care and management of these infants can be improved with practice guidelines and education (Katherine, 2012).
Katherine, Y. (2012). Implementing practice protocols and education to improve the care of infants with neonatal abstinence syndrome. Journal of Innovative Programs, 41 (1), 33.
Sublett, J. (2013). Neonatal abstinence syndrome therapeutic interventions. The American Journal for Maternal/Child care, 38 (2), 102-077. Retrieved from http: www. paediatric nursing/Nursing Center
Williamson, K. (2013). Neonatal abstinence syndrome guidelines. Ministry of Health, NSW, 5(8), Retrieved from http:www.health.nsw.gov.au/policies