Question

A nurse is caring for a patient and her newborn immediately after delivery. The patient's medication history includes prenatal vitamins throughout pregnancy, one or two glasses of wine before knowing she was pregnant, occasional use of an albuterol inhaler in her last trimester, and intravenous morphine during labor. What will the nurse expect to do?

1) Administer opioids to the infant to prevent withdrawal syndrome.
2) Monitor the infant's respirations and prepare to administer naloxone if needed.
3) Note a high-pitched cry and irritability in the infant and observe for seizures.
4) Prepare the patient for motor delays in the infant caused by the alcohol use.

Answer 1

The nurse will expect to note a high-pitched cry and irritability in the newborn and observe for seizures.

Step-by-step explanation:

The nurse will expect to note a high-pitched cry and irritability in the infant and observe for seizures.

When a pregnant woman consumes alcohol, it crosses the placenta and can affect the developing fetus. In this case, the patient had one or two glasses of wine before knowing she was pregnant, which can lead to fetal alcohol spectrum disorders (FASDs) in the newborn. Symptoms of FASDs can include a high-pitched cry, irritability, and seizures.

Administering opioids to the infant to prevent withdrawal syndrome or monitoring the infant's respirations and preparing to administer naloxone is not indicated in this scenario as there is no specific mention of opioid use by the mother during pregnancy.

The use of an albuterol inhaler and intravenous morphine during labor are not likely to have a significant impact on the infant's immediate post-delivery care.