Nursing Care Plan for Fetal Alcohol Syndrome (FAS)

Pathophysiology

Infants who were exposed to alcohol, consumed by the mother during pregnancy, results in a disorder known as Fetal Alcohol Syndrome (FAS) that can cause problems with growth and development and can lead to brain damage. The severity of the disorder in the infant can vary and normally includes a mix of physical, behavioral, and mental disorders. These children often have varying degrees of learning disabilities. The effects of FAS may not be fully recognized at birth, but may continue to develop over time, even after entering school and into adulthood.

Etiology

Fetal Alcohol Syndrome (FAS) is caused by a woman consuming alcohol while pregnant. Alcohol enters the bloodstream and crosses the placenta to the growing fetus, resulting in a much higher concentration in the baby’s blood. The alcohol in the baby’s system disrupts the delivery of oxygen to the growing tissues and organs. Since the organs are not fully developed, they cannot metabolize the alcohol and results in dysfunction of the brain, heart and physical feature deformities. Complications of exposure may arise later in the child’s life and include mental disorders, depression, ADHD, physical and sexual aggression and inappropriate behaviors that can lead to alcohol or drug use and dependency, risky lifestyles and death.

Desired Outcome

Patient will exhibit optimal cognitive functioning, appropriate behaviors and impulse control; Patient will have minimal

Fetal Alcohol Syndrome (FAS) Nursing Care Plan

Subjective Data:

Patient’s mother/caregiver may report:

  • Poor coordination
  • Jitteriness or hyperactivity
  • Frequent mood changes
  • Difficulty in social settings (daycare, school)
  • Difficulty switching tasks
  • Learning disorders

Patient may report:

  • Trouble paying attention or focusing
  • Poor memory
  • Vision problems

Objective Data:

  • Distinct facial features that include: small eyes, thin upper lip, short nose
  • Slow physical growth (before and after birth)
  • Small head circumference
  • Heart defects
  • Joint / bone deformities

Nursing Interventions and Rationales

  1. Perform complete assessment of systems including heart and lung auscultation

  2. FAS often results in deformities of the heart and lungs and may result in murmurs, heart valve disorders or respiratory diseases such as asthma

  3. Assess infant for signs of withdrawal that include:

    • High-pitched cry
    • Postural arching (of the back)
    • Slow or delayed breathing (apnea / bradypnea)
    • Slow or irregular heartbeat
  4. It is still controversial as to whether or not infants experience withdrawal symptoms.

    There are certain symptoms that appear to be consistent in infants with FAS as listed, and should be monitored if FAS is suspected.

  5. Obtain history of pregnancy from patient’s mother

    • Determine how much alcohol was consumed throughout pregnancy and frequency.
    • Severity of symptoms may be determined by amount of exposure.
    • NO amount of alcohol consumed is considered safe during pregnancy.

  6. Measure head and abdominal circumference of infant

  7. Infants with FAS generally have smaller head size that indicates microcephaly.

    Abdomen may be distended following birth. This may require nasogastric intubation.

  8. Minimize external stimuli

  9. Infants and children with FAS are often easily excitable and become agitated and fussy with excessive noise and physical stimuli.

    Maintain calm atmosphere and cluster care as much as possible.

  10. Provide education and counseling for parents/caregivers

    • Provide resources for parents that include alcohol cessation programs and support groups
    • Provide resources for child to include counseling, specialists (cardiology, neurology, orthopedics, etc) and special education programs
    • There is NO KNOWN safe amount of alcohol to be consumed during pregnancy


References

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