6 Prenatal Substance Dependence/Abuse Nursing Care Plans

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.

Here are six (6) nursing care plans (NCP) for prenatal substance dependence/abuse:

  1. Imbalanced Nutrition: Less Than Body Requirements
  2. Deficient Knowledge
  3. Ineffective Coping
  4. Situational Low Self-Esteem
  5. Powerlessness
  6. Compromised Family Coping
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Imbalanced Nutrition: Less Than Body Requirements


Imbalanced Nutrition: Less Than Body Requirements: Intake of nutrients insufficient to meet metabolic needs.

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

Desired Outcomes

  • 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
Nursing Interventions Rationale
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
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See Also


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Maternal and Newborn Care Plans


Nursing care plans related to the care of the pregnant mother and her infant. See care plans for maternity and obstetric nursing:

Further Reading


Recommended books and resources:

  1. Nursing Care Plans: Diagnoses, Interventions, and Outcomes
  2. Nurse's Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
  3. Nursing Diagnoses 2015-17: Definitions and Classification
  4. Diagnostic and Statistical Manual of Mental Disorders (DSM-V-TR)
  5. Manual of Psychiatric Nursing Care Planning
  6. Maternal Newborn Nursing Care Plans
  7. Delmar's Maternal-Infant Nursing Care Plans, 2nd Edition
  8. Maternal Newborn Nursing Care Plans