Posted: February 11th, 2023

Case Study: You are called to a postpartum room and find Michael

Review the case study and answer the following questions.

Case Study: You are called to a postpartum room and find Michael, a two-hour-old infant, irritable and spitting up copious amounts of formula. You do not know the maternal history, so you advise the mother that you would like to return the baby to the nursery for assessment and monitoring. In the medical record, you focus on the prenatal history and find the mother had an addiction to opioids with her last pregnancy but denied drug use with this pregnancy. You witness the baby having some significant tremors, vital signs: T (axillary) - 36.0, RR- 78, HR- 166, and the infant is alert, irritable, and does not console easily. The infant is constantly moving and sucking vigorously on the pacifier.
• What do you think is occurring with the infant?
• What lab test can be ordered to confirm your suspected diagnosis?
• What interventions can be implemented to treat this infant?

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Based on the information provided, it is likely that the infant is experiencing withdrawal symptoms due to exposure to opioids in utero. The symptoms described, such as irritability, tremors, increased heart rate, and difficulty consoling, are consistent with neonatal abstinence syndrome (NAS).

To confirm the suspected diagnosis, a lab test that can be ordered is a toxicology screen to detect the presence of opioids in the infant's system.

To treat this infant, a number of interventions can be implemented, including:
Monitoring and assessment: The infant should be monitored closely for changes in their symptoms and overall condition, including vital signs and feeding patterns.
Medications: In some cases, medications such as morphine or methadone may be used to manage withdrawal symptoms.
Comfort measures: Providing the infant with a quiet, calming environment and opportunities for skin-to-skin contact with the mother can help to reduce stress and discomfort.
Nutrition: The infant should be encouraged to feed frequently to prevent dehydration and maintain their weight.

It's important to work closely with the infant's healthcare provider to develop an individualized treatment plan and ensure that the infant receives the care they need to overcome their withdrawal symptoms and reach optimal health.

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