...Neonatal abstinence syndrome is a group of symptoms that result in a newborn that is exposed to opiate drugs while in utero. Newborns with neonatal abstinence syndrome experience symptoms that include uncoordinated feeding patterns, vomiting, diarrhea, dehydration, weight loss, excessive or high-pitched crying, irritability, inconsolability, yawning, temperature instability, seizures, tremors, and hypertonia. Currently, treatment for neonatal abstinence syndrome includes monitoring withdrawal symptoms, managing physiological parameters, and various supportive and pharmacologic treatments. Sadly, despite current interventions, there is not much to be done for inconsolable crying and irritable newborns with neonatal abstinence syndrome. There...
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...Neonatal Abstinence Syndrome Neonatal abstinence syndrome (NAS) is a group of complications that occur when a newborn is exposed to addictive drugs while in the mother’s womb. NAS is an increasing problem in the United States that many people are unaware of with a rise of 4.4% in 2013. It is important to understand that NAS not only affects the infant, but it affects the mother as well. Both the infant and mother can develop a wide range of symptoms ranging from mild to severe. Some of these symptoms include neurological, gastrointestinal, and autonomic disorders. Early identification of symptoms is vital to ensure that both the infant and mother receives the best care possible. Another important thing to recognize about NAS is the American...
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...* CHRONOLOGY * * Second Trimester * * Mother attended her community drug and alcohol team (CDAT) were she was on a methadone programme. Referral was made by her key worker stated concerns that she may be pregnant and concealing it * * Pre - birth conference was held to establish the issues surrounding the mother, her pregnancy and her parenting skills. Mother did not attend. The pre – birth conference attended by the CDAT key worker, safeguarding midwife, health visitor, GP, social worker. The pre – birth conference took place as mum was concealing her pregnancy and that she was heavily * * DAY 1 Jack was born by caesarean section because they were concerns with the Zoe. Zoe was unwell – she had a heart valve problem. Jack was admitted to the intensive care unit, needing ventilation support for six hours 12pm * Safeguarding midwife aware that Jack been born, states that all people who needed to be aware of baby being born are. Informed us that her current partner and father of baby are not allowed to visit. Security, front desk at the main entrance of unit and nurses made aware * Urine virology/toxicology sent * Morphine started as Jack was Ventilated due to the respiratory distress 15pm * Out of hours social worker called inquiring about baby and mum 1630pm * Maternity support worker visited unit, updated on baby’s condition. Mum had her surgery – she will go and update mum 1830pm * Nurse looking after mum on...
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...Kaisha Killion Professor Salmond Developmental Psychology 27 Sept. 2013 Substance Abuse and Pregnancy Women are incredible creatures. Women have the incredible ability to aid in the development of a new life within a matter of months. Whether a pregnancy is wanted or unplanned the process of development for the young zygote nestled within the mother’s womb is still phenomenal. The developing bundles of cells are very vulnerable from the very start to the end of a pregnancy. The progress of development for the zygote is a delicate one than can be interrupted or slowed down by many internal and external forces. The forces that can interrupt development can range from biological to environmental. The woman carrying the child is responsible for not only her life but the life of her unborn child. Many activities a mother engages in, the unborn child engages in as well. Activities that the mother participates in can be harmless such as listening to music or enjoying a healthy snack. Unfortunately, some activities are not beneficial for the new life. A mother who participates in substance abuse is putting herself and her child at risk. Substance abuse during pregnancy can have adverse effects on the mother, the unborn child, and raises an ethical dilemma. The online Merriam Webster dictionary states that “Autonomy is self-directing freedom and especially moral independence” (Merriam-Webster). Autonomy is a freedom that many individuals can exercise but it takes...
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...something that has happened. Individuals all need to go, but when it comes to taking the medicine that is given people are taking the step they never wish to go through the chance of becoming addicted. Many people ask themselves what the attraction is to the people who get themselves addicted to drugs is? A lot of people have done research to try and figure out what causes people to become addicted to drugs. Most people doing the research have failed in finding any true research to what causes people to become addicted to drugs. There are some drugs that people need to take, but the effects of other drugs is something people do not think about. There are people who are pregnant and do not realize that they are not only harming themselves but their newborn child. The problems that could happen are Alcoholic Fetal Syndrome (AFS). This is where the child is already born addicted to alcohol. When a child is born with the drugs in their systems, doctors will give them opiates. They are drugs to help the children deal with their addictions. When children are born with such addictions it is called Neonatal Abstinence Syndrome (NAS). Babies born with addictions have soared from 354 to a whopping 1,374 in 2010, that is a jump of 1,020 in just four years....
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...research critique is to inform the reader of a randomized clinical study regarding the treatment of Neonatal Abstinence Syndrome (NAS). This writer is interested in the treatment of drug exposed infants and the goals of reducing babies’ hospitalization in the Neonatal Intensive Care Unit (NICU). The study researches the adjunct therapy for treatment of NAS. The study will be broken down into the following units: protection of human participants, type of data collection utilized in the study, data management and analysis, findings and interpretation of these findings and finally the conclusion of the study and its findings. Protection of Human Participants This study’s goal is to differentiate the efficacy of clonidine versus phenobarbital in adjunct therapy with morphine sulfate in the treatment of NAS. One of the benefits of this study is the importance of standardization of a weaning protocol. The weaning protocol did not change from day to day and provider to provider as can be the case outside of the study. Another benefit is the predefined measures for each study group that were considered adverse events. These measures worked as a safety net to ensure the study was done safely and not causing harm to the babies. One noted concern/risk noted by the author was the potential for prolonged exposure to phenobarbital on a baby’s developing brain. The concern is the phenobarbital may cause behavioral compromises in the babies in the future. Informed consent was obtained from parents...
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...Alcoholism and drug abuse is a disease and affects everybody in the family. The family cannot count on them for anything. They would lie and steal money to buy drugs. They cannot keep their jobs. They don’t come home at night. They get caught by the police for drunk driving or accidents. They argue with the family members all the time, because they cause problem for the family members due to their addiction. They scream loudly, break things, walls and furniture, they might say or do wrong things that upset neighbors and friends and make the family members ashamed. When parents or other family member abuses drugs, the children in that family get hurt. The parents are unable to take care of their children. The home become unsafe for those...
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...I learned that every home may have different gender roles. So upon entering a home I again, don’t make any assumptions regarding gender or the role. Today we are moving farther and farther away from the “norm” and more single mothers are playing multiple roles in their families. For example, my 11-year-old in home client’s mom is a single parent so she plays multiple roles, this causes conflicts at times in their family. And again, this is where I come in to try and support my client in situations like...
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...Running Head: FETAL ALCOHOL SYNDROME 1 FETAL ALCOHOL SYNDROME 2 Fetal alcohol syndrome (FAS) is the most recognizable form of fetal alcohol spectrum disorders (FASD). FAS is characterized by a pattern of minor facial anomalies, prenatal and postnatal growth retardation, and central nervous system abnormalities. Those born with FAS often have behavioral and learning difficulties. The consequences of the damages caused by the mother's drinking is lifelong (Wattendorf & Muenke, 2005). To date, there has been no extensive population-based studies done (Vaux & Chambers, 2012). However, data in one sample demonstrated that approximately 1 in 100 children have alcohol-related effects. In high-risk pregnancies, predicted incidences of fetal alcohol syndrome are approximate and differ because of varied definitions of heavy drinking and inconsistent methods of diagnosis. For this reason, rates range from 4% to as much as 44%.The estimation of FAS in the United States is 1-2 cases per 1000 live births (Wattendorf & Muenke, 2005) . Fetal alcohol exposure is the leading known cause of mental retardation in the Western world. The term Fetal Alcohol Syndrome was first published in a 1973 article in the British medical journal The...
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...According to the National Institute of Drug Abuse (NIDA), drug addiction doesn’t just harm the person using, there are health risk which can be harmful to others. For example, a mother who abuses heroine can cause her unborn baby to suffer from neonatal abstinence syndrome, or (NAS). If this child grows up with drug dependency, he or she would need special medical care and education, and would have development issues. Another example is the risk of spreading infectious diseases. When drug abusers share needles while they are using cocaine, heroin or meth it makes them more susceptible to contracting Hepatitis B and Hepatitis C and accounts for 12% of new AIDS cases. It is also important to note when someone is under the influence of an illicit drug, their judgement is impaired and they may engage in irresponsible sexual behavior, making it possible for them to contract an STD (2014). These conditions are serious medical problems, which are very expensive and require advanced...
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...THE NEWBORN WITH SPECIAL CONSIDERATIONS A preterm infant is usually defined as a live-born infant born before the end of week 37 of gestation; another criterion is a weight of less than 2,500 grams (5lb 8oz) at birth I. INCIDENCE Occurs approximately 7% of live births of white infants, in Afro-American infants the rate is doubled 14% (Thilo & Rosenberg, 2003) CAUSES/FACTORS ASSOCIATED WITH PRETERM BIRTHS 1. Low socio-economic status 2. Poor nutritional status 3. Lack of prenatal care 4. Multiple pregnancy 5. Previous early birth 6. Race (non-whites have higher incidence than whites) 7. Cigarette smoking 8. Age of the mother (highest incidence is in mothers younger than age 20) 9. Order of birth (early termination is highest in first pregnancies and in those beyond 4th pregnancies) 10. Closed spaced pregnancies 11. Abnormalities of mother’s reproductive system, such as intrauterine septum 12. Infections (especially UTI) 13. Obstetric complications (PROM, premature separation of placenta 14. Early induction of labor 15. Elective cesarean birth ASSESSMENT A. History – detailed pregnancy history will reveal reason for the preterm birth; be careful not to convey disapproval of reported pregnancy behaviors such as smoking, etc. Being overburdened with guilt may be detrimental to her attempts to bond with her infant B. Appearance Criteria Posture Premature infant Resting posture – characterized by very little, if any, flexion in upper extremities and only partial flexion of...
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...Pain Assessment and Management G u i d e l i n e f o r Marlene Walden, PhD RNC NNP CCNS Sharyn Gibbins, PhD RN NNP P r a c t i c e , 2 n d E d i t i o n Pain Assessment and Management Guideline for Practice, 2nd Edition This guideline is an outline of the pain assessment and management practices that currently are accepted and documented by experts in the field of neonatal care. In addition, it summarizes and recommends pain assessment and management practices based on the best evidence for the nursing care of infants. This guideline does not preclude the use of manufacturers’ recommendations or other acceptable methods of assessing and managing pain in infants. The use of other practices known to improve the quality of neonatal care is encouraged and not restricted by this document. The National Association of Neonatal Nurses (NANN) developed this guideline in response to members’ requests. Broad in scope, it can provide a foundation for specific nursing protocols, policies, and procedures developed by individual institutions. Authors Marlene Walden, PhD RNC NNP CCNS Sharyn Gibbins, PhD RN NNP Reviewers Daniel Batton, MD, American Academy of Pediatrics Sandra Sundquist Beauman, MSN RNC Jim Couto, MA, American Academy of Pediatrics Mary Ann Gibbons, BSN RN Melinda Porter, RNC CNS NNP Ann Stark, MD FAAP, Chair of AAP Committee on Fetus and Newborn Carol Wallman, RNC NNP MS, NANN/AWHONN Liaison to AAP Committee on Fetus and...
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...Chapter I THE PROBLEM Introduction “Arming the youth with information,” one of the goals of the Reproductive Health Bill. In line with one of the two targets of Goal 5 - Improving Maternal Health - of the eight Millennium Development Goals which is achieving universal access to reproductive health by 2015. To achieve its goals, the bill provides for mandatory reproductive health education and that it be taught in "an age-appropriate manner... by adequately trained teachers starting from Grade 5 up to Fourth Year High School." As Iloilo Representative Janette Garin, author of the Reproductive Health Care Act says, “It’s very difficult to live in a society where we will be hypocritical and pretend that nothing is happening. But as early as grade 4 and 3, children, especially those in public schools, already have girlfriends and boyfriends.” Defined by United Nations (UN) on ICPD 1994, 'Reproductive health' is “a state of complete physical, mental and social well-being and...not merely the absence of disease or infirmity, in all matters relating to the reproductive system and its functions and processes.” Considering the fact that we are a Christian nation, some people and religious groups find this topic very sensitive to be discussed among youngsters. In this regard, Filipino mothers have the “you-will-learn-when-you-are-old-enough” attitude. As with this, the researchers have come up to a study that would determine the knowledge regarding reproductive health of the high...
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...disease through examination of organs, tissues, cells, and bodily fluids. Physiology is the study of the mechanical, physical, and biochemical functions of living organisms. Together, as pathophysiology, the term refers to the study of abnormalities in physiologic functioning of living beings. Pathophysiology seeks to reveal physiologic responses of an organism to disruptions in its internal or external environment. Because humans exhibit considerable diversity, healthy structure and function are not precisely the same in any two individuals. However, discovering the common and expected responses to abnormalities in physiologic functioning is useful, and it allows a general prediction of clinical progression, identification of possible causes, and selection of interventions that are most likely to be helpful. Thus, pathophysiology is studied in terms of common or “classic” presentations of disorders. Historically, descriptions of diseases were based on observations of those individuals who attracted medical attention because they exhibited...
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...Clinical guidelines Diagnosis and treatment manual for curative programmes in hospitals and dispensaries guidance for prescribing 2010 EDITION © Médecins Sans Frontières – January 2010 All rights reserved for all countries. No reproduction, translation and adaptation may be done without the prior permission of the Copyright owner. ISBN 2-906498-81-5 Clinical guidelines Diagnosis and treatment manual Editorial Committee: I. Broek (MD), N. Harris (MD), M. Henkens (MD), H. Mekaoui (MD), P.P. Palma (MD), E. Szumilin (MD) and V. Grouzard (N, general editor) Contributors: P. Albajar (MD), S. Balkan (MD), P. Barel (MD), E. Baron (MD), M. Biot (MD), F. Boillot (S), L. Bonte (L), M.C. Bottineau (MD), M.E. Burny (N), M. Cereceda (MD), F. Charles (MD), M.J de Chazelles (MD), D. Chédorge (N), A.S. Coutin (MD), C. Danet (MD), B. Dehaye (S), K. Dilworth (MD), F. Fermon (N), B. Graz (MD), B. Guyard-Boileau (MD), G. Hanquet (MD), G. Harczi (N), M. van Herp (MD), C. Hook (MD), K. de Jong (P), S. Lagrange (MD), X. Lassalle (AA), D. Laureillard (MD), M. Lekkerkerker (MD), J. Maritoux (Ph), J. Menschik (MD), D. Mesia (MD), A. Minetti (MD), R. Murphy (MD), J. Pinel (Ph), J. Rigal (MD), M. de Smet (MD), S. Seyfert (MD), F. Varaine (MD), B. Vasset (MD) (S) Surgeon, (L) Laboratory technician, (MD) Medical Doctor, (N) Nurse, (AA) Anaesthetist-assistant, (Ph) Pharmacist, (P) Psychologist We would like to thank the following doctors for their invaluable help:...
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