A nurse is caring for a newborn who is 5 days old.
Medical History

History of maternal opioid use prior to pregnancy and prescribed methadone use during pregnancy. Maternal and neonatal positive urine drug screens for methadone. Newborn is exhibiting clinical findings of neonatal abstinence syndrome (NAS).


Which of the following actions should the nurse take? Select all that apply.

Rationale:

A. "When was the last time you ate meat?": This question is not relevant for a client who adheres to a vegan diet, as they do not consume meat.

B. "Have you considered eating shellfish?": This question is not appropriate for a client who follows a vegan diet, as shellfish is not part of a vegan diet.

C. "How much protein do you eat in a day?":

Correct answer. Protein intake is an important consideration for individuals following a vegan diet, as they may need to ensure they are obtaining adequate protein from plant-based sources.

D. "Are you taking a Vitamin C supplement?": While assessing vitamin intake is important, protein intake is particularly relevant for a client following a vegan diet, as certain plant-based protein sources may be lower in certain essential amino acids compared to animal-based protein sources.

Rationale:

A. Newborns with neonatal abstinence syndrome (NAS) are often irritable and hypersensitive to stimuli. Keeping the environment calm and quiet can help minimize their discomfort.

B. Naloxone is not routinely used in the management of NAS unless there is evidence of severe respiratory depression or opioid overdose, which is not indicated in this scenario.

C. Maternal opioid use and positive urine drug screens for methadone may contraindicate breastfeeding due to the potential transmission of opioids to the infant through breast milk. It's essential to consult with healthcare providers regarding the safest feeding option for the newborn.

D. Eye contact during feeding is essential for bonding between the parent and the newborn and should not be discouraged unless medically necessary.

E. Ballard newborn screening helps assess the newborn's gestational age and guide appropriate care for neonates with NAS, as they may require specialized management.

F. Daily weighing helps monitor the newborn's hydration status and overall well-being, which is crucial in managing NAS and ensuring adequate nutrition.

G. Swaddling can provide comfort to newborns with NAS by mimicking the womb environment and reducing their agitation.