SUBSTANCE ABUSE DURING PREGNANCY Kristina Gatmaitan Anna Lutz Marvie Ramos Reuben Ramos Rosheena...
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Transcript of SUBSTANCE ABUSE DURING PREGNANCY Kristina Gatmaitan Anna Lutz Marvie Ramos Reuben Ramos Rosheena...
SUBSTANCE ABUSE DURING PREGNANCY
Kristina GatmaitanAnna Lutz
Marvie RamosReuben Ramos
Rosheena Robles
Substance Abuse Pregnancy...
• “The fetus grows & develops d/t the nourishment from the mother via the placenta.
• Toxins in the mother's system may be delivered to the fetus.
• Can cause damage to the fragile, developing fetal organs.
• Long-term effects = mental problems such as retardation and seizures.”
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Drugs and the Stages of Pregnancy
• The stage of organ formation– First ten weeks: Most of the body organs and systems of the baby-to-be are formed. During this stage, some drugs—and alcohol in particular—can cause malformations of such parts of the developing fetus as the heart, the limbs, and the facial features
•The stage of prenatal growth–After about the tenth week,
•Eyes•Nervous system risk of miscarriage & premature delivery•IUGR•Low birthweight•Death
Baby JonahJonah’s mother was a heroin addict. Shortly after birth, it was obvious Jonah was in withdrawal. His jittery movements and crying persisted for the next 2 days and there was little anyone could do to console him. He scratched his face trying to get his hands to his mouth. His knees and elbows were rubbed raw from his agitated movements, and the muscles in his tiny legs were so stiff that it was difficult to straighten his legs to diaper him.
•The full extent of the effects of prenatal drug exposure on a child is not known, however studies show that various drugs of abuse may result in premature birth, miscarriage, low birth weight, and a variety of behavioral and cognitive problems.
Drugs that may have adverse prenatal
effects:
• Cocaine • Tobacco• Heroin • Inhalants
• Marijuana • MDMA (Ecstasy)• Methamphetamine • Nicotine
Two most common drugs:
&
• The active Ingredients in Cigarette smoke are nicotine, tar, and harmful gases, such as carbon monoxide and cyanide.
• Indirect effects of cigarette smoking include decreased maternal appetite.
• Can cause neonatal prematurity and low birth weights.
• The degree of restriction of fetal growth varies with the number of cigarettes smoked daily (2009, McKinney).
• The active constituent of marijuana is tetrahydrocannabinol (THC), which crosses the placenta and accumulates in the fetus.
• Marijuana is the most commonly used illicit drug (2009, McKinney).
Factors that affect maternal smoking
Maternal age
VS
Education Level
VS
Marital Status
VS
Poverty Status
VS
Health Insurance coverage before conception
VS
Statistics• Studies from the US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration report that 3.3% of America women use illicit drugs during gestation and 80% of whom use marijuana.• The National Household Survey on Drug abuse state 2.8% of pregnant women use illicit drugs. Marijuana is used by 75% during gestation and more than 50% also use tobacco.
Statistics cont.• A study in Seattle was done on 396 females. Of them 77% reported smoking cigarettes and 50% said they smoked marijuana during pregnancy
• In the UK 15-20% of women continue to smoke throughout their pregnancy.
Statistics cont.
•A study done in the U.S. from 2002-2006 on 94,483 women found that cigarette use was reported by nearly a quarter of pregnant women in their first trimester and that 1 in 7 reported cigarette smoking in the second or third trimester.•According to the CDC approximately 13% of women smoke during the last 3 months of pregnancy
Maternal Effects of tobacco
Decreases Nutrition
Tobacco
Inability to absorb oxygen
Maternal Effects of Marijuana
Lack of coordination
Marijuana
Increased Heart Rate/decreased BP
Marijuana
Decreased oxygen
Effects of Tobacco and Marijuana on the Child
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•Prematurity•Low birth weight•Sudden infant death syndrome (SIDS)•Stillbirth•Neurodevelopmental problems•Neurobehavioral problems•Increased risk for some types of cancers•Childhood obesity
Tobacco - Effects
Article: Tobacco and Pregnancy: Overview of Exposures and Effects
Maternal-Child Nursing
Marijuana - Effects
Research Study: EXPOSURE TO MARIJUANA DURING PREGNANCY ALTERS NEUROBEHAVIOR IN THE EARLY NEONATAL PERIOD - Carvalho de Moraes Barros et al
Research Study: Prenatal Marijuana Exposure and Intelligence Test Performance at Age 6
risk of low birth weight & IUGR
risk of miscarriage, premature labor & ectopic pregnancy
• Affects memory• Developmental delays• Jitteriness• Withdrawal-like symptoms
• Behavioral problems
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RN INTERVENTIONS
RN INTERVENTIONS
• 4 A’S• Educate mother• Be supportive• Increase self-esteem
4 A’s
• According to a research article “Smoking Cessation in Pregnant Women Utilizing Evidence-Based Interventions” the rate of smoking cessation increased 30-70% when interventions (ie.4 A’s) were implemented compared to no interventions
Research Study:
Albrecht, S., PhD, RN, FAAN. “Smoking cessation in pregnant women utilizing evidence-based” Strategies in women’s health care. 2007
4 A’s
• AVOID high temptation situations -- these are situations where you know you will be tempted to smoke, or situations where you regularly smoked.
• ALTER those situations you can't avoid -- make a plan to change your behavior or some aspect of the situation so that you'll be less likely to smoke.
• ALTERNATIVES -- find other things to do besides smoking. Think ahead: What activities can you do that will distract you from wanting that cigarette?
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• ACTIVE - Get active to help you cope with urges to smoke. That's right! Get moving! Go for a short walk to clear your head and remind yourself why you want to stay smoke-free.
http://www.psychiatry.emory.edu/PROGRAMS/GADrug/Factsheets/smoking%20cessation%202.pdf
EDUCATE• Ask what they know • You as RN need to educate the mother about the dangers & side effects of their actions.
• The more informed pts are = the better educated = the more they will change their behavior
• Assess readiness to learn
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Would you let your child do this?
RN SUPPORT
• Do not threaten or frighten pt
• Give positive feedback• State facts not opinions• Refer to support groups
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Self-esteem
self-esteem = successful outcomes (smoking cessation)
• “Low self-esteem is a frequent characteristic in women who abuse drugs”
Bowie. B. H., RN, PhC, MBA “Interventions to Improve Interactions between Drug Abusing Mothers and Their Drug-Exposed Infants: A Review of the Research Literature” Journal of Addictions Nursing,161, 2005
Consequences
Conclusion
When you are pregnant, you are not just "eating for two." You also breathe and drink for two, so it is important to carefully consider what you give to your baby. If you smoke, use alcohol or take illegal drugs, so does your unborn baby
Watch this video!!!
http://www.youtube.com/watch?v=A2JUuQOlEzs
• First, don't smoke. – Smoking during pregnancy passes nicotine and cancer-causing drugs to your baby. Smoke also keeps your baby from getting nourishment and raises the risk of stillbirth or premature birth.
•Don't use illegal drugs.
– Using illegal drugs may cause underweight babies, birth defects or withdrawal symptoms after birth
ATI:1) The active ingredients in Cigarette smoke are?
a. Nicotineb. Tarc. THCd. A and B
2) All of the following systems are significantly impacted in marijuana smokers except
a. cardiovascularb. neurologicalc. genitourinaryd. Respiratory
3) Children born to women who use tobacco during pregnancy are likely to be:
a. prematureb. have low birth weightc. at increased risk for SIDSd. all of the above
4) The 4 A's include all except:a) Avoidb) Acceptc) Alterd) Alternativee) Active
If you are pregnant and you smoke, drink alcohol or do drugs, get help.
Your health care provider can recommend programs to help you
quit. You and your baby will be better off.
Numbers that can help you locate a treatment center include:
•National Drug Help Hotline 1-800-662-4357
•National Alcohol & Drug Dependence Hopeline
1-800-622-2255