What lab test can be ordered to confirm your suspected diagnosis?

Case Study: You are called to a postpartum room and find Michael, a two-hour-old infant, irritable and spitting up copious amounts of formula. You do not know the maternal history, so you advise the mother that you would like to return the baby to the nursery for assessment and monitoring. In the medical record, you focus on the prenatal history and find the mother had an addiction to opioids with her last pregnancy but denied drug use with this pregnancy. You witness the baby having some significant tremors, vital signs: T (axillary) – 36.0, RR- 78, HR- 166, and the infant is alert, irritable, and does not console easily. The infant is constantly moving and sucking vigorously on the pacifier.

• What do you think is occurring with the infant?
• What lab test can be ordered to confirm your suspected diagnosis?
• What interventions can be implemented to treat this infant?

Sample Solution

Based on the symptoms described, it is likely that the infant is experiencing symptoms of neonatal abstinence syndrome (NAS). The maternal history of opioid addiction, along with the infant’s symptoms of irritability, tremors, elevated heart rate, and difficulty consoling, are consistent with NAS. NAS can occur in newborns who were exposed to opioids in utero, leading to withdrawal symptoms after birth.

To confirm the suspected diagnosis, a lab test for opioids and other substances can be ordered. A meconium drug screen is a common test used to detect exposure to drugs in newborns.

Interventions to treat NAS can include pharmacological and non-pharmacological methods. Common pharmacological treatments include administering small doses of opioids, such as methadone or morphine, to ease the withdrawal symptoms. Non-pharmacological interventions include providing a calm and quiet environment, swaddling, and skin-to-skin contact with the mother to help the infant feel comforted and secure. Additionally, it is important to monitor the infant’s vital signs and symptoms closely and…Order a customized and more comprehensive answer here