NAS Syndrome
Pei Hwa Yin
Created on November 16, 2021
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Transcript
NAS Syndrom
NAS Syndrome
Clinical Manisfactions
Treament For NAS
Nursing Care
Treatment Goal
NAS Q&A
References
What is NAS Syndrome
What are the signs and symptoms
Medications regimes
Nursing Interventions
Nursing-361 Mother-Baby Teaching Project
NAS Syndrome Neonatal Abstinence syndrome is a group of conditions that a newborn may exhibit due to sudden withdrawal from the various substances exposed in the uterus before birth. These substance include heroin, nicotine, alcohol, cannabis, opioids, cocaine, and methamphetamine (Durham & Chapman, 2019). The most common cause of NAS can be attributed to maternal exposure to opioids during pregnancy through pain relievers, recreational drugs, or opioid maintenance therapy for opioid use disorder (CDC, 2016). The average onset of Neonatal Abstinence Syndrome depends on two factors: the type of substance a newborn was exposure in utero and the timing of the last exposure. • Neonates who exposed to the narcotics in utero can exhibit withdrawal syndrome within 2 to 3 days after birth • Neonates who exposed to alcohol in utero can exhibit withdrawal syndrome within 3 to 12 hours after birth • Neonates who exposed to the barbiturates in utero can exhibit withdrawal syndrome within 1 to 14 days after birth (Durham & Chapman, 2019).
Signs and Symptoms The major characteristics of Neonatal Abstinence Syndrome include irritability, poor feeding, autonomic instability, tremor, and loose stools. Signs and symptoms of NAS that a newborn may exhibit are listed as follow. GI, CNS, and Respiratory systems. • Diarrhea • Apnea • High-pitched cry, or excessive crying • Fever • Excessive sucking • Restless • Yawning • Tachypnea • Vomiting • Skin Mottling • Difficulty Sleeping • Weight loss or failure to gain weight. • Seizure, twitching • Nasal congestion • Sweating • Excoriation (Durham & Chapman, 2019). Complications • Risk of low birth weight, weight less than 2500 g, prematurity, and decrease in head circumferences. • Risk of pathological Jaundice that occurred in the first 24 hours of life. • Risk of dehydration. • Risk of development of congenital fetal anomalies such as having a cleft palate or vision problem. • Risk of sudden infant death syndrome often occurs in babies younger than one year old during sleeping. • Risk of developmental delay, failure to meet developmental milestones such as sitting and walking later. • Risk of impaired speech and language development and may exhibit learning difficulty. • Risk of impaired motor development such as impaired development in bone and muscle. • Risk of the ear or respiratory infections. (Durham & Chapman, 2019).
Treatments Medications Medications may be given depends on the severity of withdrawal syndrome and type of substance exposed. Medications used to treat severe withdrawal syndrome include morphine, methadone to opioid withdrawal, and benzodiazepines for alcohol withdraw. IV fluid therapy and high-calorie formula may be given to the baby if the baby is dehydrated or fails to meet the nutrition needs. Follow-up is important Newborns with NAS syndrome often need long-term care. Therefore, follow-up appointments are important. Before the baby can be discharged, referrals to the Child Protective Service are based on state laws and may be required. (Durham & Chapman, 2019; Jansson & Patrick. 2019; Texas Department of State Health Services, 2014).
Soothing Techniques • Breastfeeding • Kangaroo Care, Skin to Skin contact • Swaddling • Provide a dime, quiet environment • Rocking Nursing Cares • Assess feeding, weight, and signs of withdrawal symptoms daily. • Provide frequent, small feeding with a high-calorie formula to support increased caloric needs. The infant should be positioned upright during feeding. • Ensure rest between feeding. • Tube feeding may be required if the newborn is unable to demonstrate a productive suck. • Monitor vital signs and signs of complications. • Provide support care and education to mother. (Durham & Chapman, 2019; Jansson & Patrick. 2019; Texas Department of State Health Services, 2014)
Treatment Goal The therapy goals for a baby with NAS are to feed well, sleep well, and able to be consoled. The ultimate treatment goal is to allow baby with NAS able to function like a normal neonate.
References Centers for Disease Control and Prevention. (2016). Primary prevention and public health strategies to prevent neonatal abstinence syndrome. Centers for Disease Control and Prevention. https://www.cdc.gov/grand-rounds/pp/2016/20160816-neonatal-addiction.html. Durham, R. F., & Chapman, L. (2019). Maternal-newborn nursing: The critical components of nursing care. F.A. Davis Company. Jansson, L. M., & Patrick, S. W. (2019). Neonatal Abstinence Syndrome. Pediatric clinics of North America, 66(2), 353–367. https://doi.org/10.1016/j.pcl.2018.12.006 Texas Department of State Health Services. (2014, October 14). Stronger Together: NAS Soothing Techniques for Mommies and Babies [Video]. YouTube. https://www.youtube.com/watch?v=7IFLrd8zudo
How is NAS diagnose ? An accurate report of the mother's drug usages is important for treating and diagnosing the newborn with Neonatal Abstinence Syndrome. In addition, a NAS scoring system can help with the diagnosis of the NAS and determine the severity of NAS. The Baby's meconium and urine are also obtained to test the existence of the substance. Physical assessment can also help identify the S&S of NAS (Durham & Chapman, 2019). What is the average length of hospital stay of a newborn with NAS? According to CDC (2016), a newborn with NAS generally can be discharged in 23 days. What is the most effective way to prevent NAS occurrence? According to CDC (2016), prescriptions of opioid to productive-age women is common, and many women who expose their fetus to opioid do not know they are pregnant initially. Therefore, educating women on topics related to improving preconception health is the key to preventing NAS. Women who are using drugs that can cause NAS should also be instructed to use contraceptive measures. It's time to play Kahoot!