What Is Neonatal Abstinence Syndrome Health Essay

What Is Neonatal Abstinence Syndrome Health Essay Neonatal Abstinence Syndrome is a term used to define a group of problems a newborn will exhibit due to exposure for drugs like opiates, narcotics or anti-depressant during pregnancy. As almost every drug that passes through the mothers bloodstream is passed on to the placenta. Therefore any illicit drug abuse will lead the foetus to utero exposure of these substances which will make it physically dependent, same effect that will do the mother herself. Therefore, after the baby is born, this dependence still continues, but since he is no longer maintained through the placenta which passes on anything his mother has in her bloodstream, after some time, depending on the drugs active ingredient half-life, this supply of substance will be no longer available. This lack will lead the neonates central nervous system to become overstimulated causing withdrawal symptoms. Why is NAS a concern? The abuse of illicit drugs from a mother, not only puts the newborn at risk for NAS but even many other syndromes. These risks are mainly increased due to high chance that being a drug user, the pregnant mother may be reluctant to seek prenatal care, and therefore any conditions or complications the mother may be going through during the prenatal stage are not being screened by any medical specialist. A fact to consider is that most drug users, usually dont abuse of only one substance, which usually would lead to several complications during treatment of the newborn for withdrawals. Moreover, if the mother is an intravenous drug user, there is high probability of passing on to the child any infections acquired following use of infected needles, namely; HIV/AIDS. Apart from the NAS symptoms the neonate may have other problems related to this drug use which include; poor intrauterine growth, premature birth and birth defects. More problems were observed from the abuse of recreational drugs before and during pregnancy and findings through studies found that some drugs frequently cause specific problems in babies, for example; the use of heroin and opiates, like methadone, is likely to cause substantial withdrawal in the baby, with certain symptoms lasting between four to six months. Methadone users babies have a higher probability of seizure episodes than others. The use of marijuana reduces birth weight and size of the newborn, likewise with use of amphetamines, which in turn even increases the chance of premature birth and may be the cause of intracranial bleeding in the neonate. Cocaine abuse is mostly associated with poor foetal growth and may be even related to a higher risk of sudden infant death syndrome (SIDS). These similar problems at birth are not only seen with illicit drug use, but even use of alcohol and cigarette smoking does damage the foetus. Complications with regards to alcohol abuse called foetal alcohol spectrum disorders (FASDs), include slow growth both during and after pregnancy, specific deformities of head and face, heart defects and mental retardation. Smaller babies, premature births and stillbirths are at a higher chance of encounter to smoking women. Symptoms Nearly all substances lead to some sort of effect on the newborn, but NAS symptoms may differ with the type of drugs, doses taken, how long the mother abused from these drugs and whether the baby was born premature or full-term. Incidence of NAS varies with strength of drugs; Heroin and Methadone are more likely to cause NAS, although drugs like Cocaine, Amphetamines, Barbiturates (Anti-Convulsive) and Narcotics may also lead to withdrawal symptoms. Alcohol use during pregnancy can also cause withdrawals in a baby. Neonate can start to appear symptomatic as early as 24 hours to 48 hours after birth, when strong drugs with short half-life were used, or as late as 5 to 10 days with weaker and longer half-life drugs. Withdrawal symptoms as a consequence of alcohol abuse during pregnancy may begin within a few hours after birth. Common symptoms may include; excessive/high pitched crying, diarrhoea / vomiting, irritability to light/sound, trembling (jittering), seizures, sweating, fever, hyperactive reflexes, excessive sucking, poor feeding and slow weight gain, rapid breathing, insomnia, increased muscle tone and skin irritation. A neonatal is diagnosed with NAS when he/she exhibits a combination of these signs, since several signs may also be experienced by newborn having other problems, the baby will have to be closely checked to confirm NAS. A history of the mothers drug use during pregnancy, as accurate as possible, will be required to proceed with the necessary tests. This is argued about its reliability especially when mother, or worse, both parents are illicit drug abusers, but for the sake of the newborn, a background of what substance the child maybe withdrawing from is of extreme importance to start the right treatment to manage withdrawals as soon as possible. Diagnosing withdrawals in a newborn may require tests like; urinalysis, toxicology screen of first bowel movements (meconium) and typically an NAS scoring system is used. By means of assigning points to certain signs and symptoms and their severity, this NAS scoring system apart from helping to diagnose, it also aids in grading the severity of the withdrawal and may even help in treatment planning. Therefore once born and transferred to the postnatal ward, the baby is assessed for signs of withdrawals by the midwives using the NAS scoring chart. If the repeatedly four hourly assessments will get a score of 8 or higher, a doctor will be notified and it may be necessary for the baby to be transferred to the Neonatal and Paediatrics Intensive Care Unit (NPICU) to start any necessary treatment for the withdrawal symptoms observed. Treatment Treatment for NAS will be determined by a paediatric physician and will be specifically based on the neonates gestational age and overall health, the extent of disease, the babys tolerance for specific medications and therapies and expectations for the course of the disease. Neonates suffering from withdrawal are irritable and frequently hard to calm and to get comfortable. Snugly wrapping the baby in a blanket, gently rocking the baby and reducing lights and sounds usually helps a bit to manage this irritability exhibited. A higher-calorie formula may be recommended for the extra calories necessary due to their increased activity. Intravenous (IV) fluids are sometimes necessary to avoid the newborn becoming dehydrated due to severe vomiting or diarrhoea. Depending on the severity of the withdrawal symptoms, babies may need medications to help relieve the discomfort and other complications of withdrawal, seizures in particularly. The drug of choice is usually a drug similar to the one the mother used during pregnancy, which therefore is the substance the baby is withdrawing from, then dosage is slowly reduced when withdrawal symptoms are managed. Benzodiazepines are usually used for alcohol withdrawals and methadone for heroin and other opiate withdrawal. Prevention An attempt to break the cycle of reproductive morbidity or mortality starts from identifying substance abuse. Most of the birth defects mentioned to be cause of illicit drug use, could be possibly less if the mother stops using drugs as soon as she finds out she is pregnant or if possible before. Preferably both men and women should stop abusing of any drugs before conception itself to further reduce the chance of birth defects which can occur not only through the gestation stage, but even at gametogenesis. Whilst with most birth defects the termination of drug abuse from mother does only lower their probability, in the case of NAS this could be completely prevented, therefore is encourage to stop any abuse and seeking prenatal care. Drug screening at this stage prevents fully the transmission of any substances through the placenta to the foetus avoiding any future dependence. Health education is currently focusing on these problems as to prevent this growing social problem phenomenon to become oversized. Prognosis Children of drug dependents, do not only go through a rough period in the first days of their life due to the utero exposure of illicit substances, but also various longer lasting, or worse, lifelong medical disabilities will be incurred due to the exposure to different types of drugs. Adding up is the fact of the social challenges as son/daughter of a drug addict, for example, being socially left out from school friends or other groups. Moreover, looking at the economic aspect, which may be due to the persisting drug dependence of either or both parents, could easily be critical and lead to a low standard of living. Definitely the prognosis widely varies with all these variables, but surely if this drug addiction of any of the parents wont cease, it will be of no help for the baby, hopefully in good health, to have an amusing future ahead. Long-term problems in children, who were exposed to illicit substances during gestation, may symptoms related to adverse neurodevelopmental outcomes leading to low IQ scores from births to methadone and cocaine users. The perception, speech and intellectual functions were found to suffer some disturbances to youngsters who were exposed to opiate drugs. Major part of the children born to a illicit substance abusing mother have been reported to suffer from behavioural problem, such as; low levels of learning and adapting to new situations and high sensitivity to their environment causing irritability, agitation, aggression, poor social skills. Marijuana use during pregnancy was associated with increased impulsivity, delinquency and hyperactivity exhibited in the exposed kids. None of the treatments used to treat NAS was proved to affect any final outcome of this prenatal exposure. Epidemiology Internationally, from the UK Advisory Council on the Misuse of Drugs it is suggested that 6,000 babies, i.e. 1% of UK births, are born to drug abusing mothers each year. Due to their availability and recreational use cocaine, methadone and other illicit substance are now being preferred to the past higher ratio of heroin abusers. A broader image shows us that as much as European women use opioids during pregnancy as analgesic treatment, the number of pregnant women abusing of other drugs is somewhat similar. In Malta, although on low scale its still increasing in incidence from year to year. This is most likely due to the more common day to day recreational drug use around teenager and slightly older generations. Along with the availability, dependencies on certain substances have increased, leading to abuse from mothers even during pregnancies and the newborn suffering from NAS as an end result. From a conversation with a nurse from NPICU revealed me that the number of NAS in Malta is around 0.4% of all births in our country, but a number which is disturbingly on an incline. Conclusion Neonatal Abstinence Syndrome and any other birth defects are usually topics that no one would like to converse about, as usually talking about these fragile human beings, born with some sort of problem, either being congenital or lifestyle-induced during gestation, does make both parties feel uneasy. Nonetheless avoiding to talk about these wont lower their incidence, it is actually the opposite, proper health education is one way where one can teach what someones habits can lead to. It is a known fact that there is little we can do with congenital conditions, but we can reason out that a least we should not help the number of premature births or still births increase. NAS is one of many conditions, which I personally think that recent changes in our lifestyles can easily lead us to newborns having similar problems. Main reason being, the increment of habitual/recreational drug use and availability amongst 14-30 age bracket, is probably one of the highest ever seen. Not considering the exaggerate number of alcohol abusers, which also can lead to similar conditions. In addition to the other problems linked to promiscuous sexual relationships leading to higher risks of infection which can easily be transmitted and later inherited by a newborn. Anti-drug abuse campaigns do already show some of the consequence these substances will do to your body. But maybe sometimes things look amplified and interest is lost whilst listening or even looking at a leaflet. More evident data should be used to incept the thought in the minds that these conditions are not out of this world, and clearly outline any possible remedies to prevent themselves and their babies from going through unnecessary pain. I would like to conclude saying that nowadays life presents us with enough and may be too many challenges. If we can minimize these with some thought and assertiveness, we can make at least our nuclear sized life a better place. Temptations during hard times do arise, but it is not fair on anyone to suffer from our bad decisions, especially those that should be a symbol of our love to life.

Torture and Fear in the Handmaids Tale

The action or practice of inflicting severe pain on someone as a punishment or to force them to do or say something, or for the pleasure of the person inflicting the pain. The handmaids tale is a novel by Margaret Atwood, It describes the life of a woman who is documenting her life as it goes on, As the book progresses we are able to see the amount of torture (physical and mental) that the woman of Gilead receive. Offred and other women in Gilead are well aware of Gilead’s rules and Offred acknowledges the punishments and the torture she will endure if she does not obey.Throughout the novel we can begin to see Offred disobey the rules and begin fighting the totalitarian regime. Gilead’s rules are enforced by ‘god’ which makes adds guilt to whoever breaks them as you are technically disobeying god. People are very likely to do things when religion is involved and Gilead uses that to its advantage especially when they add the fear and punishment of death. Ser ena joy, the wife of the commander was a strong advocate for submissive female roles before the war and before the formation of Gilead.The creation of Gilead has lead Serena Joy to become a housewife. Before the Formation of Gilead, Serena joy used to be a preacher, She emphasized how woman should stay home and how they belong at home. After the totalitarian regime began, Serena Joy quickly realized how she preaches where misdirected, As Offred quotes â€Å"She doesn’t make speeches anymore; she has become speechless (pg 56) this is a clear demonstration of how Gilead took her words and twisted them to their advantage and to have power over her and other woman, and with power comes fear.Serena joy was once a very powerful woman but due to the fact that she cannot reproduce she has very little purpose in society, which begins to create jealousy over Offred who is fertile. Serena feels very resentful over Offred as she has the chance to reproduce and that she is having a sexua l relationship with her husband. Serena is forbidden to show any resentful behaviour and must show only gratitude and acceptance towards Offred otherwise her actions would be punishable.The effect of negativity towards someone else is highly forbidden as it creates conflict and any social interaction is illegal and will result in severe consequences. The amount of fear the Gilead produces over its society is the key factor to keeping control over them. In Gilead, Women are stripped of their pride. They are taken away and isolated from their families and loved ones. Gilead uses this method as a strong method of torture as it leaves women with scared thoughts and broken hearts; inevitably this makes women very weak and desperate.Offred explains how her husband Luke and her child where taken away from her when they tried escaping the new society. We learn how effective this method of torture is by how Offred is haunted by the thoughts of her daughter and Gilead strictly forbids her to feel any form of emotion; this puts Offred in constant risk especially due to the fact that she suffers throughout the whole novel. In Gilead you are forbidden to be seen in public unsupervised, thus you are forced to be paired with a stranger. You are refused to see your partners face and create unnecessary discussion.Gilead enforces a physiological fear that a group called the ‘Eye’. The name the ‘Eye’ comes from the all foreseeing eye which means you are being watching you all the time. This builds a fear that no matter what you do you are going to be judged and evaluate it and if you are seen crossing limits you will be punished. This causes Women (and men) to be narrowed down and remain quiet. The Eye is a very effective mechanism of fear as it strips women from their individuality and eventually causes them to stop thinking. The fear it generates is very immense and it deals a torture.If one is being unlawful and disobedient, you are required by law t o report them. Trust is exceptionally hard to build in the new society. Gilead takes this to its advantage as if trust cannot be sustained, that means communication will be cut off; without communication people will eventually fall into depression and feel utterly lonely. Physiological torture is very effective in a society such as Gilead as it allows 100% control over what the people do. Gilead also portrays torture by placing disobedient women on the jail wall, hung by their necks. They are placed in public so that everyone is able to see them.The government officials keep control by forcing women attend ‘salvaging’s’ in which they are forced to view the execution of woman who’s crimes are not announced. Religion plays a major role in fear. It is used to ensure people fear breaking rules as they would be breaking something that god set them out to do. They are in fear that if they do something in which can result in a consequence, or the fact that they a re doing something illegal, they are breaking Gods trust; The Gilead uses that to their advantage as they have greater control if the society is influenced by religion.Gilead follows an obligatory rule in which woman are forced to have a male counterpart, Gilead is a male controlled society but no matter how much woman are disregarded, they are essential for the successors of the society. Being fertile in Gilead is the only form of power a woman receives, infertile woman are often quickly disregarded. Gilead creates an atmosphere in which if you are capable of producing life, you are granted the chance to live. Women who are infertile are usually disposed of in outskirts of the city cleaning radioactive material or hung.

Critical Thinking Skills Creating Change - 1400 Words

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Individualism in Robert Frosts The Road Not Taken,...

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