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Substance Abuse NUR 113 Debbie Hogan RN Tobacco • Effects of nicotine-constriction of blood vessels • Produces smaller placenta=SGA infant • Cessation program Alcohol • Crosses the placenta as soon as in mom’s blood • Effects are noted with neuro functioning • Fetal Alcohol Syndrome • Advise mom-NO ETOH Prescription Drugs • Schedule II, III, and IV • Other Rx • Rx for health problems-is drug tetrogenic? Illicit Drugs • • • • • Marijuana Cocaine Methylamphetamine Opiates Other drugs Effects of Illicit Drugs • Mom’s often do not seek prenatal care if abusing drugs • Placenta-small • Fetus-SGA, addiction at birth, long term developmental delays • Cessation/education/rehab/clinics Nursing Care for Mom with Substance Abuse • • • • • • • Determine type and amount of substance How long has fetus been exposed When was last “encounter” Mom’s weight/fundal height/FHR Plans after delivery Social Services involvement Mom’s support Nursing Care for Babe Exposed to Substance Abuse • • • • • Determine drug(s) Fundal height/SGA Resuscitative measures NICU Foster Care Conclusion • NO NICOTINE • NO ETOH • NO ILLICTS Survival Tips for Nurses • When dealing with substance abuse moms – – – – Establish trust-you need to help babe Use therapeutic communication Avoid being judgmental/biased Make referrals if necessary