Prenatal substance dependence involves phase of group of behavioral, cognitive, and physiological symptoms such as inability to control over drug abuse and repetitive use of the substance inspite of adverse maternal and fetal effects. These consequences include poor nutrition/weight gain, anemia, predisposition to infection, pregnancy induced hypertension, low birth weight, intrauterine growth restriction, fetal alcohol syndrome (FAS). The drugs most commonly abused are nicotine, alcohol, marijuana, heroin, phencyclidine (PCP), opiates, cocaine, and methamphetamine. Treatment depends on the degree of abuse and whether the client is addicted or is in the withdrawal phase. The client who is intoxicated may not seek care during the prenatal period, compounding any existing or developing problems. In addition, negative attitudes on the part of society and often from caregivers affect the pregnant woman and her care. A return to health consists of gaining a mastery and control over self and environment, and pleasure seeking that does not require the use of drugs.
Nursing Care Plans
Nursing care plan goals for a pregnant client experiencing substance abuse may include promoting physiological stability and well-being of mother and fetus, supporting client’s acceptance of reality of situation, facilitating learning of new ways to decrease anxiety, strengthening individual coping skills, incorporating client into supportive community environment, promoting family involvement in treatment process and providing information about condition, prognosis, and treatment needs.
- Imbalanced Nutrition: Less Than Body Requirements
- Deficient Knowledge
- Ineffective Coping
- Situational Low Self-Esteem
- Compromised Family Coping
Imbalanced Nutrition: Less Than Body Requirements
- Imbalanced Nutrition: Less Than Body Requirements
May be related to
- Inadequate dietary consumption in fulfilling metabolic needs for physiological, psychological, or economic purposes
Possibly evidenced by
- Decreased subcutaneous fat/muscle mass
- Lack of appetite and loss of interest in food
- Below maternal Prepregnant weight
- Protein and vitamin deficiencies
- Reported altered taste sensation
- Sore, inflamed buccal cavity
- Weak muscle tone
- Client will verbalize understanding of effects of substance dependence and insufficient dietary intake on the nutritional status and pregnancy.
- Client will demonstrate behaviors and lifestyle changes to regain/maintain an appropriate weight for pregnancy.
- Client will demonstrate progressive weight gain toward goal, with normalization of laboratory values and absence of signs of malnutrition
|Assess condition of the oral cavity. Note and record age, height/weight, body build, strength, and activity/rest pattern.||Guides the formation of the dietary plan. The condition of mucous membranes and teeth may be affected by the type of food intake.|
|Determine anthropometric measurements such as BMI, waist-to-hip ratio, skin-fold test and bioelectrical impedance.||Measures subcutaneous fat and muscle mass to help in planning dietary needs.|
|Note total daily calorie intake. Encourage client to keep a journal of intake, frequency, and patterns of eating.||Information about client’s dietary pattern will determine nutritional strengths, needs, and insufficiencies.|
|Review and discuss prenatal nutritional needs and develop a dietary plan. Assist with developing a grocery budget and provide an opportunity to select food items to meet dietary plan.||Facilitate involvement in the plan and resolves nutritional deficiencies.|
|Assess energy expenditure (such as pregnancy needs, pacing or sedentary activities) and set an individualized exercise program.||Pregnant state and activity level affect nutritional needs. Exercise improves muscle tone, may promote appetite and raises sense of well-being.|
|Note and record client’s weight weekly.||Provides information regarding current status or effectiveness of dietary plan|
|Collaborate with a dietitian.||Helps in establishing individual dietary needs. Provides an additional resource for learning about the importance of nutrition in nonpregnant and pregnant states.|
|Review laboratory studies as indicated such as glucose, serum albumin, and electrolytes.||May reveal electrolyte imbalances, anemia and other abnormalities that may be present, requiring specific therapy.|
|Assist client in consultation with a dentist as necessary.||Healthy teeth are important in having a good nutritional intake, and dental hygiene is often overlooked in this population|
Recommended nursing diagnosis and nursing care plan books and resources.
- Nursing Care Plans: Nursing Diagnosis and Intervention (10th Edition)
An awesome book to help you create and customize effective nursing care plans. We highly recommend this book for its completeness and ease of use.
- Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
A quick-reference tool to easily select the appropriate nursing diagnosis to plan your patient’s care effectively.
- NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023 (12th Edition)
The official and definitive guide to nursing diagnoses as reviewed and approved by the NANDA-I. This book focuses on the nursing diagnostic labels, their defining characteristics, and risk factors – this does not include nursing interventions and rationales.
- Nursing Diagnosis Handbook, 12th Edition Revised Reprint with 2021-2023 NANDA-I® Updates
Another great nursing care plan resource that is updated to include the recent NANDA-I updates.
- Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5(TM))
Useful for creating nursing care plans related to mental health and psychiatric nursing.
- Ulrich & Canale’s Nursing Care Planning Guides, 8th Edition
Claims to have the most in-depth care plans of any nursing care planning book. Includes 31 detailed nursing diagnosis care plans and 63 disease/disorder care plans.
- Maternal Newborn Nursing Care Plans (3rd Edition)
If you’re looking for specific care plans related to maternal and newborn nursing care, this book is for you.
- Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care (7th Edition)
An easy-to-use nursing care plan book that is updated with the latest diagnosis from NANDA-I 2021-2023.
- All-in-One Nursing Care Planning Resource: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health (5th Edition)
Definitely an all-in-one resources for nursing care planning. It has over 100 care plans for different nursing topics.
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database
Over 150+ nursing care plans for different diseases and conditions. Includes our easy-to-follow guide on how to create nursing care plans from scratch.
- Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing
Our comprehensive guide on how to create and write diagnostic labels. Includes detailed nursing care plan guides for common nursing diagnostic labels.
Other care plans related to the care of the pregnant mother and her infant:
- Abruptio Placenta | 3 Care Plan
- Abortion (Termination of Pregnancy) | 8 Care Plans UPDATED!
- Cesarean Birth | 10 Care Plans UPDATED!
- Cleft Palate and Cleft Lip | 6 Care Plans
- Dysfunctional Labor (Dystocia) | 4 Care Plans
- Gestational Diabetes Mellitus | 8 Care Plans UPDATED!
- Hyperbilirubinemia (Jaundice) | 4 Care Plans UPDATED!
- Labor Stages, Induced and Augmented Labor | 36 Care Plans UPDATED!
- Neonatal Sepsis | 5 Care Plans
- Perinatal Loss | 5 Care Plans
- Placenta Previa | 3 Care Plans
- Postpartum Hemorrhage | 8 Care Plans UPDATED!
- Postpartum Thrombophlebitis | 5 Care Plans UPDATED!
- Prenatal Hemorrhage | 9 Care Plans UPDATED!
- Prenatal Substance Dependence/Abuse | 6 Care Plans
- Precipitous Labor | 3 Care Plans
- Preeclampsia and Gestational Hypertension | 6 Care Plans UPDATED!
- Premature Dilation of the Cervix | 3 Care Plans
- Prenatal Infection | 3 Care Plans
- Preterm Labor | 7 Care Plans UPDATED!
- Puerperal & Postpartum Infections | 5 Care Plans UPDATED!