COCAINE EXPOSURE

SALMERO, Maria Alena Rose S. RIVERA, Gianna

WHAT is COCAINE?
Known as CRACK A CNS stimulant and peripheral sympathomimetic [effects can be direct or indirect] Indirect effects- fetal hypoxemia secondary to impaired uterine blood flow. Affects fetal cardiac function and suppresses the fetal immune system.

 Prenatal cocaine exposure (PCE) occurs when a pregnant woman uses cocaine and thereby exposes her fetus to the drug Crack baby was a term coined to describe children who were exposed to crack (cocaine in smokable form) as fetuses

How does cocaine hurt an unborn baby?

During the early months of pregnancy, cocaine may increase the risk of miscarriage. Later in pregnancy, it may trigger preterm labor (labor that occurs before 37 completed weeks of pregnancy) or cause the baby to grow poorly. It also may cause an unborn baby to die or to have a stroke, which can result in irreversible brain damage

METHOD
More reliable methods for detecting cocaine exposure involve testing the newborn's hair or meconium (the infant's earliest stool). Hair analysis, however, can give false positives for cocaine exposure. The mother's urine can also be tested for drugs.

CLINICAL MANIFESTATION
Apnea Jitteriness Cardiac arrythmias IVH Decreased head circumference Transient electroencephalogram abnormalities

 Poor response to auditory, arousal and visual stimuli Delayed language acquisition Poor impulse Abnormal reflexes Behavioral problems at school Poor NBAS score Significant cognitive delays the first 2 years

Therapeutic Management
Newborns urine , hair(rarely), or meconium sampling may be required to identify intrauterine drug exposure.

NURSING CARE MANAGEMENT

Make sure the environment is modified to decreased noxious stimuli. Useof swaddling, containment, gentle rocking, NNS, and undisturbed periods of rest may help promote self-containment and state regulation. Avoidance of breastfeeding Provide an environment suitable for the newborn and the mother so they may interact imperatively.