lecture 5

Question 1

supervised consumption sites benefits:

Answer 1

reduces overdose and physical harm, reduces community harm discarded needles, decreased healthcare costs, safety

Question 2

supervised consumption sites drawbacks

Answer 2

fear of bringing criminal element into neighborhoods, message that use is acceptable

Question 3

fentanyl test strips test:

Answer 3

unregulated drugs for the contamination of fentanyl and various analogs in powder and pill form

Question 4

fentanyl test strips do not provide a:

Answer 4

quantity of fentanyl present in the substance

Question 5

a negative result on a fentanyl test strop does not guarantee

Answer 5

substance is free from fentanyl or other synthetic opioids

Question 6

neonatal abstinence syndrome:

Answer 6

passive exposure to a newborn from a neuroactive drug, when the infant is deprived of these substances a withdrawal syndrome may develop

Question 7

which drug is most associated with NAS?

Answer 7

opiates/opioids

Question 8

cost and average stay for hospital stay for newborn with NAS:

Answer 8

7,800 in 2020, 9 days compared to 2 days for other newborns

Question 9

opioid use during pregnancy has a greater risk of these on baby:

Answer 9

low birthweight, respiratory problems, third trimester bleeding, toxemia and mortality

Question 10

toxicology screening of newborns:

Answer 10

Urine, poop, hair

Question 11

poop detects from which trimester?

Answer 11

2nd

Question 12

hair detects from which trimester?

Answer 12

3rd, need 20-50 mgs

Question 13

neurobehavioral dysregulation sensory processing:

Answer 13

hyper/hypo. visual auditory tactile

Question 14

neurobehavioral dysregulation state control/attention

Answer 14

lability, staring, irritability, gaze aversion

Question 15

neurobehavioral dysregulation autonomic control:

Answer 15

respiration, gastrointestinal, skin temp/color

Question 16

neurobehavioral dysregulation motor and tone control:

Answer 16

tremors, seizures, coordination problems

Question 17

the hallmark of neonatal withdrawal is a:

Answer 17

sticking disorder of movement or “jitteriness”, GI problems such as vomiting and food intolerance, rapid breathing nasal flaring due to breathing difficulties

Question 18

autonomic over-reactivity:

Answer 18

yawning, sneezing, fever, excessive or continuous cry, tremor

Question 19

excoriation:

Answer 19

rubs their chins, knees, elbows, nose and toes against blankets, sheets or clothing

Question 20

cerebral irritation:

Answer 20

term used to describe perceived pain that a newborn experiences which is of unknown. hypertonic and irritability, difficulty nursing from a bottle or mother

Question 21

which gender has been reported to have more severe NAS expression?

Answer 21

male infants

Question 22

which infant has less severe expression?

Answer 22

preterm infants

Question 23

NICU care may _____ NAS severity while maternal rooming-in can ____ it

Answer 23

increase; reduce

Question 24

onset of withdrawal for methadone:

Answer 24

24-72 hours

Question 25

onset of withdrawal for heroine

Answer 25

within 24 hours

Question 26

onset of withdrawal for Suboxone

Answer 26

within 48 hours

Question 27

infants are monitored for how many days for signs of withdrawal because of what?

Answer 27

7 days bc of rare cases of late onset

Question 28

finnegan scoring system:

Answer 28

assessment for NAS which helps quantify the severity of the withdrawal and are used as a guide to start, wean, and discontinue treatment

Question 29

a normal newborn can have scores as high as:

Answer 29

8, anything greater requires treatment

Question 30

Non-pharmacologic Management

Answer 30

decrease environmental stimuli, dim lighting, peaceful and quiet environment, swaddle, pacifier, tactile stimulation

Question 31

observational assessment that guides Tx:

Answer 31

can the infant eat more than 1 oz per feed or breast feed well? can the infant sleep more than 1 hour? can the infant be consoled within 10 minutes? if so, discontinue treatment

Question 32

true of false, Newborn babies exposed to opioids or the medication for opioid use disorder should not breastfeed.

Answer 32

false, encouraged to breastfeed unless they have illicit drugs in system

Question 33

pharmacologic management:

Answer 33

morphine or methadone administered every 4 hours, monitored for respiratory distress, for an increase in consitpation and weight loss. phenobarbital for severe NAS, benzos used in cases of polysubstance abuse

Question 34

children exposed to opioids found reduced regional volumes in these brain areas:

Answer 34

cortex, amygdala, basil ganglia and reductions in head circumference

Question 35

how many states consider substance use during pregnancy child abuse?

Answer 35

25 and the District of Columbia