AUTHOR'S NOTE

Since this is a syndrome nursing diagnosis, no related factors are necessary. The etiology of the syndrome is substance abuse by infant's mother.

The major domains of dysfunction resulting in signs and symptoms in the infant with NAS are (Jansson, 2019):

• Sleep and wake cycle disturbances manifested by fragmented sleep with short sleep cycles and difficulty maintaining an alert state.
• Alterations in tone or movement manifested by hypertonicity, tremors, or jitteriness.
• Autonomic dysfunction manifested by sweating, sneezing, mottling, fever, nasal stuffiness, and frequent yawning.
• Easy overstimulation, sensitivity, or hyperarousal resulting in irritability and crying with any stimuli.
• Infants may also have difficulties with feeding (suck-swallow incoordination and oral hypersensitivities resulting in poor weight gain, respiration (tachypnea) and gastrointestinal problems (gassiness, vomiting, loose stools).
• Birth weight <10th percentile for gestational age (GA) due to intrauterine growth restriction
• Possible cardiac birth defects.

This syndrome requires highly specialized medical and nursing interventions, which are beyond the scope of this book. Please refer to the appropriate neonatal textbook.