Care of Mother and Child At-Risk or with

Problems (Acute and Chronic)- Lecture

STUDENT ACTIVITY SHEET BS NURSING / SECOND YEAR
Materials:
Book, pen, SAS and notebook

LESSON TITLE: CARE OF THE HIGH-RISK

PREGNANT CLIENT (PRE-GESTATIONAL
CONDITIONS-SUBSTANCE ABUSE)
Reference:
LEARNING OUTCOMES: Pilliteri, Adele and Silbert-Flagg, JoAnne (2018)
At the end of the lesson, the student nurse can: Maternal and Child Health Nursing, 8th Edition.
USA: Lippincott Williams and Wilkins
1. Define types and effects of substance abuse to
pregnancy, including preexisting factors that contribute to its
development such as cardiovascular disease.

2. Integrate knowledge of substance abuse to nursing

process to achieve quality maternal and child health nursing
care.
Session # 3

LESSON PREVIEW/REVIEW (5 minutes)

MAIN LESSON (50 minutes)

A Woman who is Substance Dependent
(Chapter 22: Nursing Care of Pregnant Family with Special Needs, page 584)

Substance Abuse- inability to meet major role obligations, increase in legal problems or risk-taking behavior, or exposure
to hazardous situations due to an addicting substance.

Substance dependent- if she has withdrawal symptoms after discontinuation of the substance

These substances are usually of low molecular weight & can readily cross the placenta; the fetus has 50% drug
concentration as that of the mother Common substances abused:
1. cocaine
2. amphetamines
3. marijuana
4. alcohol
5. inhalants
6. opiates
7. phencyclidine

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1. Cocaine-most frequently abused drug during Cocaine Use
pregnancy, Amphetamines-methamphetamines (speed) has
causes extreme vasoconstriction severely effects similar to cocaine
compromising fetal circulation leading to premature
separation of the placenta resulting to preterm labor or Newborn symptoms:
fetal death. jitteriness, poor
feeding, growth
Fetal withdrawal symptoms of COCAINE: restriction
tremulousness,
irritability, muscle
rigidity,
learning defects (later on in life),
intracranial hemorrhage
Detected by urinalysis
2. Marijuana or hashish- when smoked causes tachycardia & a sense of well-being.
- Used to counteract nausea in early pregnancy Effects:
1. loss of short-term memory,
2. reduced milk production
3. incidence or respiratory infection
4. excretion of drug in breast milk

3. Phencyclidine (PCP)-animal tranquilizer frequently used as a street drug

-increases cardiac output & gives a sense of euphoria
-causes hallucinations (flashback episodes)
-tends to leave the maternal circulation & concentrate in fetal cells
4. Narcotic Agonists-used for pain (morphine or Withdrawal symptoms
meperidine), cough suppression (codeine); is a potent Nausea and Vomiting
analgesic and provides euphoric effect. Diarrhea abdominal
HEROIN- main opiate used recreationally & is used ID pain Hypertension
(skin-popping), by snorting or IV (shooting) Restlessness
- Produces immediate but short-lived euphoria followed Shivering
by sedation Insomnia body
aches muscle
jerks Fetal
effects:
Small for Gestational Age
increased incidence of fetal distress
meconium aspiration
Management: methadone maintenance program
during pregnancy

5. Inhalants- airplane glue, cooking sprays, computer keyboard cleaner

Refer to sniffing or huffing of aerosol drugs
May lead to severe cardiac and respiratory irregularities May
limit fetal O2 supply
6. Alcohol-causes cognitive challenges and memory deficits
Fetal alcohol Syndrome-is a condition in a child that results from alcohol exposure during the mother's pregnancy.
Fetal alcohol syndrome causes brain damage and growth problems.

CHECK FOR UNDERSTANDING (30 minutes)

You will answer and rationalize this by pair. This will be recorded as your quiz. One (1) point will be given to correct
answer and another one (1) point for the correct ratio. Superimpositions or erasures in you answer/ratio is not allowed.

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Multiple Choice

1. A newborn has a condition that results from alcohol exposure during the mother's pregnancy that causes
brain damage and growth problems. Which of the following condition does the newborn has? A. Substance
Abuse
B. Fetal Alcohol Syndrome
C. Drug Abuse
D. HIV/AIDS
ANSWER: ________
RATIO: : Fetal alcohol syndrome is a condition in a child that results from alcohol exposure during the mother's
pregnancy, Fetal alcohol syndrome causes brain damage and growth problems

2. An 18-week pregnant client was caught sniffing cooking spray at the Female comfort room You know using
this type of drug may lead to severe cardiac and respiratory irregularities and may limit fetal oxygen supply.
Which of the following does the pregnant client is using?
A. Heroin
B. Marijuana
C. Phencyclidine
D. Inhalants
ANSWER: ________
RATIO: Inhalants refer to sniffing or huffing of aerosol drugs.

3. A 24-week pregnant client is using a drug recreationally she use it by “snorting”. What drug does the client is
using?
A. Heroin
B. Marijuana
C. Phencyclidine
D. Inhalants
ANSWER: ________
RATIO: HEROIN- main opiate used recreationally & is used ID (skin-popping), by snorting or IV (shooting).

4. A 12-week pregnant client is smoking a “weed”. You know that this type of substance that when smoked
causes tachycardia & a sense of well-being and is used to counteract nausea in early pregnancy. A. Heroin
B. Marijuana
C. Phencyclidine
D. Inhalants
ANSWER: ________
RATIO: Marijuana or hashish when smoked causes tachycardia & a sense of well-being. Used to counteract nausea in
early pregnancy

5. A 27-week pregnant client is using an “animal tranquilizer”. You know as a nurse that frequent use or a street
drug that increases cardiac output, gives a sense of euphoria and causes hallucinations. Which of the following
drug is the pregnant woman is using?
A. Heroin
B. Marijuana
C. Phencyclidine
D. Inhalants
ANSWER: ________
RATIO: Phencyclidine (PCP)-animal tranquilizer frequently used as a street drug.

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6. A 37-week pregnant woman gave birth to a newborn and is experiencing Heroin withdrawal symptoms. The
following are Heroin Withdrawal Symptoms, EXCEPT:
A. Intracranial hemorrhage
B. Restlessness
C. Shivering
D. Insomnia
ANSWER: ________
RATIO: The following are Heroin Withdrawal Symptoms, except A. intracranial hemorrhage, which is a fetal withdrawal
symptom of COCAINE.

7. A pregnant woman is using cocaine. You know as a nurse that once she will give birth, her child will
experience Cocaine Withdrawal Symptoms. The following are Withdrawal symptoms for Cocaine, EXCEPT:
A. tremulousness
B. irritability
C. muscle rigidity
D. restlessness
E. intracranial hemorrhage ANSWER: ________
RATIO: The following are Withdrawal symptoms for Cocaine of the child, except D. restlessness which is a withdrawal
Symptom of Heroin and Narcotic Agonists.

8. You interviewed a pregnant client using a Marijuana to manage her nausea. You know the effect of Marijuana
use in pregnant women and with the fetus. EXCEPT:
A. loss of short-term memory
B. reduced milk production
C. intracranial hemorrhage
D. incidence or respiratory infection
ANSWER: ________
RATIO: The following are effect of Marijuana use in pregnant women and with the fetus, except C. Intracranial
hemorrhage, which is a fetal withdrawal symptom of COCAINE

9. A pregnant woman asked you what are the effects of Narcotic use with the fetus. You answered the following,
EXCEPT:
A. Small for Gestational Age
B. Increased incidence of fetal distress
C. Meconium aspiration
D. Restlessness
ANSWER: ________
RATIO: The following are effects of Narcotic use with the fetus except D. Restlessness which is a withdrawal
symptom.

10. A pregnant client asked you what are the effects of Phencyclidine (PCP). You answered the following,
EXCEPT:
A. increases cardiac output
B. gives a sense of euphoria
C. loss of short-term memory
D. causes hallucinations ANSWER: ________
RATIO: The following are the effects of Phencyclidine (PCP), except C. loss of short-term memory which is an
effect of Marijuana or hashish.

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RATIONALIZATION ACTIVITY (THIS WILL BE DONE DURING THE FACE TO FACE INTERACTION)
The instructor will now rationalize the answers to the students. You can now ask questions and debate among yourselves.
Write the correct answer and correct/additional ratio in the space provided.

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LESSON WRAP-UP (5 minutes)

You will now mark (encircle) the session you have finished today in the tracker below. This is simply a visual to help you
track how much work you have accomplished and how much work there is left to do.

You are done with the session! Let’s track your progress.

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PERIOD 2

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PERIOD 3

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AL STRATEGY: CAT: Student Response Cards

1. The instructor will give you response card and will explain the choices that was included with the card.
2. The Instructor will give a question to the class regarding information just covered in your lesson.
3. Hold up your card with the corresponding answer to the instructor’s question.

(For next session, review Chapter 21: Nursing Care of A Family Experiencing a Sudden Pregnancy
ComplicationIsoimmunization, p.558.Chapter 26: Nursing Care of Family with a High Risk Newborn-Illnesses that
Occur in
Newborns. P. 704)

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