Clinical management of methadone dependence during pregnancy.

This is a review of the literature regarding the clinical management of pregnant women maintained on methadone treatment. The prevalence of opiate use, definition of opiate dependence, common concerns regarding methadone use in pregnancy, and maternal/fetal harm are addressed. Recommendations for nurses are synthesized from the clinical literature, clinical experiences, and the empirical literature. These recommendations address: antepartum issues including treatment, dosage and pharmacological considerations, medical conditions and lab tests, intrapartum issues, postpartum concerns including breastfeeding, neonatal withdrawal, and developmental effects associated with methadone.

Systemic lupus erythematosus in pregnancy.

For the pregnant woman with systemic lupus erythematosus (SLE), there is a potential for profound effects on perinatal outcome. Because SLE is a multisystem disease, there are numerous effects on and nursing implications for the mother, the fetus, and the newborn that require individual case management. The article discusses SLE in pregnancy as well as appropriate clinical management and therapeutic intervention to assist the perinatal and neonatal nurse in caring for the mother, fetus, and neonate.

Preceptorships in high-risk perinatal nursing for rural nurses: a pilot project.

A need existed in New Mexico to enhance the skills of nurses in rural areas in the management of high-risk perinatal patients. However, barriers prohibited initiating such a program, including: a) program development and approval; b) legal and insurance issues; c) determining financial responsibility; and d) application and selection process. Resolving these problems came in the form of a collaborative effort among three departments at the University of New Mexico. A preceptor program of clinical and classroom experiences was developed for nurses outside of the Albuquerque metropolitan area. Evaluations of the program at six months revealed that program participants had implemented changes in their nursing practice. Revisions of the program and plans for the future are discussed.

Facilitating perinatal grieving between the mother and the father.

Society often expects mothers and fathers to share equally in the perinatal grief process because the child was a common bond between them. Unfortunately, in perinatal grief, this is not always the case. The mother and the father can experience incongruent grieving and use discordant coping mechanisms. It is important to evaluate these differences to facilitate communication between the distraught parents. Improved communication can in turn facilitate the grieving process.

Drug-taking behaviours of pregnant substance abusers in treatment.

The purpose of this research was twofold: to describe the types of drugs and alcohol abused by pregnant multisubstance abusers enrolled in a substance abuse and treatment programme, and to describe the types of changes in drug-taking behaviours during pregnancy. An exploratory study, including interviews and chart reviews, was conducted with 31 pregnant multisubstance abusers. Drug-taking behaviours, demographic factors of age, ethnicity, martial status, education, and pregnancy characteristics of gravida, living children, level of prenatal care and trimester of pregnancy were measured. Most of the women were in their Twenties, Hispanic, single and had some high school education. Most of the women were multiparas to grand multiparas, yet they had only one or two living children, and all were receiving prenatal care. Their self-reports were validated by urine screening. Generally, the women reported that they did change their drug-taking behaviours, and many women decreased their substance abuse.

Changes in health behaviors made by pregnant substance users.

A descriptive survey was conducted with 31 pregnant women who were substance users enrolled in a perinatal treatment program. The purpose of the study was to determine the women's health behaviors by using open-ended questions. Most of the women were between 20 and 29 years of age, Hispanic, not married, unemployed, and had partial or completed high-school education. The women had multiple pregnancies with few living children. The majority of the women were 4 to 6 months pregnant and all had received prenatal care. The women made health behavior changes during pregnancy related to nutrition, substance use, self-care, exercise, lifestyle, and seeking counseling. Over 52% of the women reported they made these behavioral changes because they wanted a healthy baby.

Self-esteem of pregnant substance abusers.

PROBLEM: To explore patterns and levels of self-esteem of pregnant substance abusers. METHODS: A descriptive prospective study to describe the self-esteem of pregnant substance abusers. Subjects (N = 31) were abusing and dependent on three or more legal and/or illegal substances. Subjects were asked one open-ended question regarding their self-esteem, then the Rosenberg Self-Esteem Inventory (RSI) was administered. FINDINGS: Subjects gave 46 responses to the open-ended question. Overall, they used a single word to describe self-esteem. The most frequent response on the RSI was "low" for self-esteem, 23 subjects used positive terms, 20 used negative terms, and 3 reported a neutral term. The RSI confirmed the aspects of low self-esteem. CONCLUSIONS & IMPLICATIONS FOR NURSING: Problems with low self-esteem were evident. Intervention strategies need to be developed to increase self-esteem in pregnant substance abusers.

Amnioinfusion: an update.

Amnioinfusion is one of the most innovative techniques of the decade. The authors reviewed current literature, research indications, and nursing implications for amnioinfusion. Current technology has simplified the amnioinfusion procedure. This technique provides both therapeutic and prophylactic regimens for the intrapartum mother and her fetus, and it has many clinical implications for nursing.