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 D
Explanation
The newborn should be placed in prone position to prevent pressure to the lesion which may lead to damage to the contents of the sac. It should be covered with a sterile, wet gauze to maintain the integrity of the sac.
Correct Answer is B
Explanation
Lochia rubra, which is bright red and may contain small clots, is the normal postpartum vaginal discharge that occurs during the first few days after childbirth. It indicates the shedding of the uterine lining and is expected during the early postpartum period. A midline and firm fundus at the level of the umbilicus suggests appropriate uterine involution, indicating that the uterus is contracting effectively to expel lochia and decrease in size.
Given these findings, there is no immediate concern requiring intervention.
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