SUBSTANCE ABUSE & PREGNANCY

CARE OF MOTHER, CHILD – AT RISK OR WITH PROBLEMS (ACUTE AND CHRONIC)

BSN 2022-2023|Sophomore 2nd Sem, Prelim
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SUBSTANCE ABUSE
• A growing health problem in women of childbearing
age
• As many as to 10% to 20% of pregnant women admit
using illicit substances during pregnancy
• Common illicit substances used - marijuana, cocaine
and methamphetamine.
• Adolescents have an increased rate of inhalant abuse
and binge drinking.
• Substance abuse – the inability to meet major role
obligations, an increase in legal problems or risk
taking behavior or exposure to hazardous situation
because of an addicting substance.
• Substance dependent person – when he or she has
withdrawal symptoms following discontinuation of the
substance, combined with abandonment of important
activities, spending increased time in activities related
to the substance use, using substance for a longer
time than planned, or continue use despite worsening
problems because of substance use.
• Addiction – a compulsive need to use a substance
for its satisfying or pleasurable effect
• Withdrawal – physical and psychological sx
occurring when drug is no longer being used
• Tolerance – ability of the body tissue to endure and
adapt to continued or increased use of a substance
SUBSTANCE COMMONLY ABUSED DURING
PREGNANCY
• Cocaine
• Amphetamines
• Marijuana and Hashish
• Phencyclidine (PCP)
• Narcotic Agonists
• Inhalants
• Alcohol

NURSING CARE OF THE PREGNANT WOMAN

UNDER SUBSTANCE ABUSE
NURSING ASSESSMENT
• Possible signs of substance abuse
• History
o History of vague or unusual medical complaints
o Family history of alcoholism or other addiction
o History of childhood physical, sexual or emotional
abuse
o History of high-risk sexual behavior
o Psychiatric history of treatment and/or hospitalization

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• Physical Examination • The woman gives birth to healthy infant.
• Physical signs • The woman agrees to accept a referral to social
o Dilated or constricted pupils services (or another appropriate community agency)
o Inflamed oral mucosa for follow-up care after discharge.
o Evidence of needle “track marks” or abscesses
o Poor nutritional status
o Slurred speech or staggering gaits
o Odor of alcohol on breath
• Behavioral signs
o Memory lapses, mood swings, hallucinations
o Pattern of frequently missed appointments
o Frequent accidents, falls
o Signs of agitation, depression, euphoria
o Suicidal gestures
NURSING DIAGNOSIS
• Imbalanced Nutrition: Less than Body Requirement
related to inadequate food intake secondary to
substance abuse.
• Risk to Injury to self and fetus related to chronic
substance dependency
• Risk for Infection related to use of inadequately
cleaned syringes and needles secondary to
intravenous (IV) drug use.
• Risk for Ineffective Health Maintenance related to a
lack of information about the impact of substance
abuse on the fetus.
PLANNING
THE WOMAN WILL:
• Identify the harmful effects of substances on herself
and her infant
• Verbalize feelings related to continued use of harmful
substances
• Identify personal strengths and accept resources
offered by the health care delivery system to stop
using drugs
IMPLEMENTATION
ANTEPARTUM PERIOD
• Examining attitudes
• Preventing substance abuse
• Communicating with the woman
• Helping the woman identify strengths
• Provide ongoing care
INTRAPARTUM PERIOD
• Preventing injury
- Setting limits
- Initiating seizure precautions
• Maintaining effective communication
• Providing pain control
POSTPARTUM PERIOD
• Nursing care is focused on helping the mother with:
- Bonding
- planning and providing care for herself and her
infant
EXPECTED OUTCOMES
• The woman is able to describe the impact of her
substance abuse on herself and her unborn child.
• The woman has enrolled in a substance dependency
treatment program and consequently has reduced or
is no longer abusing any substances

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