A nurse is caring for a newborn who is 72 hr old.
Physical Examination
1100:
Neonatal Abstinence Scoring System (NAS)
Excessive high-pitched cry-2 Sleeps <2 hr 2
Hyperactive Moro reflex=2 Moderate-severe tremors disturbed=2 Increased muscle tone=2
Fever <37.2 to 38.2° C (99 to 100.8° F)=1
Excessive sucking=1 Frequent sneezing=1
Frequent yawning-1 Loose stools=2 Poor feeding=2
Respiratory rate > 60/min=1 Mottling-1
NAS score 20
The nurse is planning to contact the provider regarding the newborn's status. Which of the following prescriptions should the nurse anticipate? Select the 3 interventions the nurse should anticipate.
Swaddle the newborn.
Administer naloxone for NAS scores greater than 24.
Continue NAS scoring as prescribed.
Encourage the birthing parent to breastfeed.
Administer oral morphine.
Correct Answer : A,C,D,E
A.Swaddling can provide comfort to the newborn and may help reduce symptoms of NAS such as tremors and increased muscle tone.
B. Naloxone is not routinely used in the management of neonatal abstinence syndrome (NAS). Naloxone is an opioid antagonist and is not recommended for the treatment of NAS due to the risk of precipitating acute withdrawal in the newborn, which can be life-threatening.
C. Continuing NAS scoring as prescribed is an appropriate intervention. It helps assess the severity of withdrawal symptoms and guides the management plan.
D. Breastfeeding is often encouraged in newborns with NAS as it provides comfort, nutrition, and promotes bonding between the newborn and the birthing parent.
E. Administering oral morphine is one of the pharmacological treatments commonly used for moderate to severe cases of NAS. It helps to alleviate withdrawal symptoms in the newborn and is often titrated based on the severity of symptoms and NAS scoring.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Inserting a gloved hand into the vagina to relieve pressure on the cord. This helps to prevent compression and compromise of blood flow to the fetus.
The other cations can follow the relief of pressure i.e B, D, C
Correct Answer is D
Explanation
A. Early decelerations are usually benign and are associated with head compression during contractions.
B. Accelerations are increases in the fetal heart rate above the baseline. They are typically reassuring and indicate fetal well-being.
C. Late decelerations are concerning patterns in fetal heart rate monitoring. They can indicate poor oxygenation of the fetus and may be associated with conditions such as maternal hypotension, placental insufficiency, or other factors compromising blood flow to the fetus.
D. Variable decelerations are abrupt decreases in fetal heart rate that vary in timing, duration, and depth. They are often associated with umbilical cord compression, such as when the cord is being compressed or squeezed during contractions.
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