Chemical and the Neonate Chapter 20


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Chemical and the Neonate Chapter 20

  1. 1. Chemical and the Neonate Chapter 20
  2. 2. Fetal Alcohol Exposure and the Brain <ul><li>describes a pattern of birth defects found in children of mothers who consumed alcohol during pregnancy </li></ul><ul><li>Today, FAS remains the leading known preventable cause of mental retardation </li></ul><ul><li>Behavioral and neurological problems associated with prenatal alcohol exposure may lead to poor academic performance as well as legal and employment difficulties in adolescence and adulthood </li></ul><ul><li>Despite attempts to increase public awareness of the risks involved, increasing numbers of women are drinking during pregnancy (NIAAA National Institute on Alcohol Abuse and Alcoholism) </li></ul>
  3. 3. Scope of the Problem <ul><li>A period of special vulnerability </li></ul><ul><li>60% of the blood that the fetus receives from the umbilical cord is processed by the liver before it proceeds to the rest of body </li></ul><ul><li>In the US: </li></ul><ul><ul><li>19% of women will use alcohol </li></ul></ul><ul><ul><li>20% smoke cigarettes </li></ul></ul><ul><ul><li>5.5% use illicit drugs </li></ul></ul><ul><ul><li>At some point during pregnancy </li></ul></ul>
  4. 4. Definitions and Incidence <ul><li>FAS is defined by four criteria: maternal drinking during pregnancy; a characteristic pattern of facial abnormalities; growth retardation; and brain damage, which often is manifested by intellectual difficulties or behavioral problems (3). When signs of brain damage appear following fetal alcohol exposure in the absence of other indications of FAS, the condition is termed &quot;alcohol-related neurodevelopmental disorder&quot; (ARND) (3). NIAAA </li></ul>
  5. 5. Specific Cognitive and Behavioral Impairments <ul><li>Attention. </li></ul><ul><li>Visual-Spatial Learning spatial relationships among objects </li></ul><ul><li>Verbal Learning language and memory </li></ul><ul><li>Reaction Time how quickly the brain processes information </li></ul><ul><li>Executive Functions (i.e., activities that require abstract thinking, such as planning and organizing). </li></ul>
  6. 6. Other effects <ul><li>Page 262 </li></ul>
  7. 7. fetal alcohol spectrum disorders (FASDs) <ul><li>has emerged to address the need to describe the spectrum of disorders related to fetal alcohol exposure. It is an umbrella term describing the range of effects that can occur in an individual whose mother drank alcohol during pregnancy. These effects can include physical, mental, behavioral, learning disabilities, or a combination of these, with possible lifelong implications. </li></ul>
  8. 8. FAS <ul><li>FAS is a permanent condition. It affects every aspect of an individual’s life and the lives of his or her family. However, FAS is 100% preventable—if a woman does not drink alcohol while she is pregnant. </li></ul>
  9. 9. Is there any safe amount of alcohol to drink during pregnancy? <ul><li>There is no known safe amount of alcohol that a woman can drink during pregnancy. There is also no safe time during pregnancy to drink alcohol. Alcohol can have negative effects on a fetus in every trimester of pregnancy. Therefore, women should not drink if they are pregnant, planning to become pregnant, or could become pregnant (that is, sexually active and not using an effective form of birth control). </li></ul>
  10. 10. Refer to breakout sessions for other drugs <ul><li>Cocaine </li></ul><ul><li>Amphetamine </li></ul><ul><li>Opiate </li></ul><ul><li>Marijuana </li></ul><ul><li>Cigarettes </li></ul>
  11. 11. Special Populations <ul><li>CHAPTER 21 </li></ul>
  12. 12. Hidden Faces <ul><li>Women </li></ul><ul><li>Elderly </li></ul><ul><li>Homosexuals </li></ul><ul><li>Disabled </li></ul><ul><li>Ethnic Minority </li></ul>
  13. 13. Buzz Session <ul><ul><li>Count your points only if your group answers the following: </li></ul></ul><ul><ul><li>1. scope of the problem </li></ul></ul><ul><ul><li>2. Impact of the use of chemicals </li></ul></ul><ul><ul><li>3. Treatment considerations </li></ul></ul><ul><ul><li>4. What are the barriers you think that an individual in your identified group faces in treatment </li></ul></ul>
  14. 14. Chapter 23 <ul><li>CHEMICAL USE BY CHILDREN AND ADOLESCENTS </li></ul>
  16. 16. Problem <ul><li>80% of 18 yr. olds have used alcohol at least once </li></ul><ul><li>4% use regular </li></ul><ul><li>66% of 18 yr. olds have tried cigarettes </li></ul><ul><li>13% smoke at least ½ pack per day </li></ul>
  17. 17. Special vulnerability <ul><li>Those that use in adolescence are at greater risk to become addicted </li></ul><ul><li>16% of children who experiment with marijuana before that age of 12 will go on to use heroin, compared to only 8% of those whose first marijuana exposure is after the age of 12 </li></ul><ul><li>Attachment bonds help protect them from addictions </li></ul>
  18. 18. Controversy <ul><li>Some believe any use is a serious problem </li></ul><ul><li>Others believe that “experimental” use is a part of adolescence </li></ul><ul><li>What do you think? </li></ul><ul><li>Page 305 </li></ul>
  19. 19. Scope of the problem <ul><li>Estimate nationally that 800,000 adolescents between 12 and 17 are thought to be addicted to an illicit drug </li></ul><ul><li>Alcohol is popular-parental denial </li></ul><ul><li>45% of older than 12 admit to using alcohol at least once in the past 30 days </li></ul>
  20. 20. Why worry? <ul><li>Brain still developing </li></ul><ul><li>“Gateway” drug theory </li></ul>
  21. 21. Tobacco Use <ul><li>Avg. age a smoker begins is age 12 </li></ul><ul><li>Which are regular smokers at age 14 </li></ul><ul><li>In US avg. of 6,000 adolescents start smoking every day, ½ become daily users </li></ul><ul><li>1997 major lawsuit </li></ul><ul><li>Parental influence </li></ul><ul><li>Victimization theory </li></ul><ul><li>Rebellion </li></ul>
  22. 22. Tweed (1998) symptoms of adolescent SA problem <ul><li>Weight loss </li></ul><ul><li>Nasal irritation </li></ul><ul><li>Frequent colds or allergies </li></ul><ul><li>Hoarseness </li></ul><ul><li>Chronic cough </li></ul><ul><li>Unexplained injuries </li></ul><ul><li>Needle tracks </li></ul><ul><li>Social withdrawal </li></ul><ul><li>Promiscuity </li></ul><ul><li>Fights </li></ul><ul><li>Hiding bottles.drug paraphernalia </li></ul><ul><li>Selling possessions </li></ul><ul><li>Legal problems </li></ul><ul><li>Drastic change in sleep patterns </li></ul>
  23. 23. Problems with diagnosis <ul><li>Standards for diagnosis and treatment are primitive and there is little research done </li></ul><ul><li>Referrals for evaluation often come from juvenile court system, schools </li></ul><ul><li>Many of the evaluations are done by the treatment center and not an independent evaluator </li></ul><ul><li>Adolescents tend to have immature view of life, fatalistic-misinterpreted by treatment staff as “denial” </li></ul>
  24. 24. Diagnosis <ul><li>Stages page 314 </li></ul><ul><li>Criteria page 317 </li></ul>