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Disorders affecting psychosocio-cultural behaviors: substance abuse
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Assessment: pregnant substance abuser
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Medical history
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Infections: HIV-positive status, AIDS, STDs, hepatitis, cirrhosis, cellulitis, endocarditis, pancreatitis, pneumonia.
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Psychiatric illness: depression, paranoia, irritability.
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Trauma related to violence.
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Obstetric history
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Spontaneous abortions.
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History of abruptio placenta
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Preterm labor.
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Preterm rupture of membranes.
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Fetal deat
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Low-birth-weight (LBW) infants.
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Tremors/seizures.
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Current pregnancy
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Preterm labor contractions.
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Hypoactivity or hyperactivity in fetus.
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Poor or decreased weight gain.
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STD
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Undiagnosed vaginal bleedin
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Drugs being used and methods of self-administration.
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Psychosocial history
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Attitudes re: pregnancy.
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Current support system: lacking
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Current living arrangements; lifestyle
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History of psychiatric illness.
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History of physical, sexual abuse
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Involvement with legal system.
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Physical examination
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Commonly abused substances
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Nicotine
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Alcohol (fetal alcohol syndrome ([FAS] or fetal alcohol effects [FAE])
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Marijuana
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Stimulants - cocaine, crack, ice, methamphetamine
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Opiates - heroin, methadone, Darvon, codeine, Vicodin, Oxycontin.
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Sedatives, hypnotics.
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Caffeine
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Ecstasy.
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Neonatal outcomes
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LBW, small heads.
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Irritable, difficult to console
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Disorganized suck-swallow reflex.
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Impaired motor development.
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Congenital anomalies: genitourinary, gastrointestinal, limb anomalies.
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Cerebral infarctions.
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Breastfeeding contraindicated unless mother is drugfree for 3 months.
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Poor, slow weight gain; failure to thrive
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Analysis/nursing diagnosis:
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Altered nutrition: less than body requirements - poor weight gain related to poor nutrition.
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Altered nutrition: less than body requirements - slow fetal growth related to slow gain in weight.
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Altered placental function related to high risk for abruptio placenta
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Noncompliance with health care protocols related to persistent drug use
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Altered parenting related to psychological illness (substance dependence).
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Nursing care plan/implementation:
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Early identification of substance abuser.
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Stabilize physiological status.
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Fetal surveillance
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Urge consistent obstetric car
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Refer for social services.
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Evaluation/outcome criteria:
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Seeks out and uses social services and drug treatment program.
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Abstains from illicit substances during pregnancy.
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Successfully completes an uneventful pregnancy, labor, and birth of normal healthy infant.