Passage / Scenario

Exhibit 1: Medical History ├óÔé¼┬ó History of maternal opioid use prior to pregnancy and prescribed methadone use during pregnancy. ├óÔé¼┬ó Maternal and neonatal positive urine drug screens for methadone. ├óÔé¼┬ó Newborn is exhibiting clinical findings of neonatal abstinence syndrome (NAS). Exhibit 2: Nurses' Notes at 0700hrs ├óÔé¼┬ó Newborn exhibits a continuous high-pitched cry and has minimal sleep. ├óÔé¼┬ó Tremors and hyperactive Moro reflex noted. ├óÔé¼┬ó Increased muscle tone and excessive sucking observed. ├óÔé¼┬ó Newborn has uncoordinated sucking and swallowing during feeding. ├óÔé¼┬ó Newborn appears irritable and difficult to console. ├óÔé¼┬ó Skin mottling and frequent yawning observed. ├óÔé¼┬ó Sneezing and nasal stuffiness noted. Nurses' Notes at 0900hrs ├óÔé¼┬ó Newborn continues to exhibit a high-pitched cry and minimal sleep. ├óÔé¼┬ó Tremors persist, with increased frequency and intensity. ├óÔé¼┬ó Hyperactive Moro reflex remains evident. ├óÔé¼┬ó Muscle tone remains increased, with excessive sucking still observed. ├óÔé¼┬ó Feeding difficulties continue with uncoordinated sucking and swallowing. A nurse is caring for a newborn who is 5 days old in the neonatal intensive care unit (NICU).