A pregnant client has a history of opioid dependence. Which of the following are appropriate nursing interventions for managing her care? Select all that apply.
Advise the client that occasional drug use is safe during pregnancy
offer nonjudgmental counseling and referrals to support services
Encourage abrupt discontinuation of all opioids
Monitor the newborn for signs of neonatal abstinence syndrome (NAS)
Provide methadone therapy as prescribed
Correct Answer : B,D,E
A. This is incorrect. There is no safe level of illicit opioid use during pregnancy. Encouraging or implying safety could put both the mother and fetus at serious risk, including preterm labor, low birth weight, and neonatal abstinence syndrome (NAS).
B. Providing a supportive, nonjudgmental approach encourages the client to engage in care, disclose substance use, and access rehabilitation, counseling, and social services, which improves maternal and fetal outcomes.
C. Abrupt cessation of opioids in a dependent pregnant client can lead to maternal withdrawal, fetal distress, preterm labor, or miscarriage. Safe management involves medically supervised opioid replacement therapy, not sudden discontinuation.
D. Infants exposed to opioids in utero are at risk for NAS, which includes tremors, irritability, feeding difficulties, respiratory problems, and seizures. Early identification and intervention are essential.
E. Methadone or buprenorphine therapy is the standard of care for managing opioid dependence during pregnancy. These therapies stabilize maternal opioid levels, reduce illicit drug use, and improve pregnancy outcomes. Therapy should be medically supervised.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Rho(D) immune globulin (RhoGAM) is indicated when an Rh-negative mother gives birth to an Rh-positive infant. This prevents the mother’s immune system from developing antibodies against Rh-positive blood cells, which could cause hemolytic disease of the newborn (HDN) in future pregnancies.
B. An Rh-positive mother already has the D antigen, so she will not form antibodies against an Rh-negative baby. RhoGAM is not needed.
C. The mother is Rh-positive and cannot develop antibodies against Rh-positive fetal blood cells. No RhoGAM is required.
D. Both mother and baby are Rh-negative, so there is no risk of maternal sensitization. RhoGAM is not indicated.
Correct Answer is C
Explanation
A. Referred pain occurs when pain is perceived in an area different from the site of the actual tissue damage (e.g., shoulder pain from gallbladder disease). In this scenario, the pain is localized to the joints, not referred, so this is incorrect.
B. Procedural pain is short-term pain associated with medical procedures such as injections, IV insertions, or surgeries. Persistent joint pain lasting 4 months is not related to a procedure, so this is incorrect.
C. Chronic pain is defined as pain that persists longer than 3 months or beyond the expected period of healing. This 13-year-old has had joint pain for 4 months, meeting the criteria for chronic pain. Chronic pain in juvenile arthritis can affect physical activity, school performance, and psychosocial well-being, and requires long-term management strategies.
D. Acute pain is short-term, sudden in onset, and usually associated with tissue injury or inflammation, typically resolving within days to weeks. Pain lasting 4 months exceeds the acute timeframe, so this is incorrect.
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