Nursing Care Plan | NCP Prenatal Substance Dependence/Abuse

This disorder is a continuum of phases incorporating a cluster of cognitive, behavioral, and physiological symptoms that include loss of control over use of the substance and continued use of the substance, despite adverse maternal/fetal consequences (e.g., poor nutrition/weight gain, anemia, predisposition to infection, PIH, fetal defects/IUGR, fetal alcohol syndrome [FAS]). The drugs most often abused are alcohol, cocaine (crack), heroin, methamphetamine, barbiturates, marijuana, and phencyclidine (PCP). Care depends on the degree of abuse and whether the client is intoxicated or is in the withdrawal phase. The client who is addicted 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 Plan Priorities

1. Promote physiological stability and well-being of client and fetus.

2. Support client’s acceptance of reality of situation.

3. Facilitate learning of new ways to reduce anxiety; strengthen individual coping skills.

4. Incorporate client into supportive community environment.

5. Promote family involvement in treatment process.

6. Provide information about condition, prognosis, and treatment needs.



Nursing Care Plan Discharge goals

1. Free of injury/complications to self and fetus/newborn.

2. Engaged in treatment modalities by identifying and using support systems.

3. Responsibility for own life and behavior assumed.

4. Abstinence from drug(s) maintained on a day-to-day basis.

5. Dependence condition and its impact on pregnancy, prognosis, and therapeutic regimen verbalized.

6. Participation in follow-up care by making and keeping all appointments, managing therapeutic regimen.