Clonidine 5.5mcg PO Q3H

Hydrocortisone 1% DAILY

Vitamin D Drops DAILY

Baby is under the care of the Ministry

Foster parents provide support during night feeds

Limited daytime caregiver presence

Diagnosis: Neonatal Abstinence Syndrome (NAS)

Feeding 60 mL Q3H via bottle, which is appropriate volume for age

Feeding pattern is consistent

• has poor coordination of suck/swallow reflex, and feeding intolerance

has experienced recent weight loss (-2g past 1 day)

Mother is aware the baby is under the Ministry

RR within normal limits for age

No signs of respiratory distress (no nasal flaring, grunting, retractions)

On room air

Rash noted on cheek area

Redness noted on neck, and crown of head

Possible irritation from frequent movement

Skin appears intact

Biological Mom received no prenatal care

• Known to have taken Effexor, Seroquel, Cocaine, Risperidone

Baby shows signs of discomfort, including jitteriness and poor sleep (per kardex).

Non-verbal pain cues: high-pitched cry, restlessness, difficulty settling

Foster parents have support from the Ministry, including resources for managing NAS and infant care.

Social worker support for both the baby and the foster parents

Cuddler Volunteer provided comfort during shift

Foster parents involved during night feeds

Adequate wet diapers

No stool observed during shift

Erikson’s stage: Trust vs. Mistrust (infant needs consistent comfort/care)

Also Piaget’s Sensorimotor stage, learning through touch, movement

Given the baby's age, assessment of normal developmental milestones would be appropriate.

Clonidine dose increased to better manage NAS symptoms

24-hour oxygen monitoring initiated

RDW 15 H

Plt count 641 H

Potassium 6.2 H

Chloride 112 H