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Written Case 1 Baseline IRR Assessment

Read Written Case 1 before completing the Assessment. Enter your information below and click “Start” to begin. 

*Note: If you did not enter credentials to log in to this training, you must complete all fields below to receive full credit. For assistance, contact Catrice Banks-Johnson.

*Click the link below the case to download the document.

Nurse/Provider Sign-out

  1. 2-day-old full-term baby boy born to 1st time mom.
  2. Mom using street oxycodone in pregnancy. Had been having irregular periods and didn’t discover pregnancy until ~ 5 months.
  3. Tried stopping oxycodone abruptly but went through withdrawal and had significant cravings. Started taking Subutex from her friend as she heard this was safer and was worried that she would use heroin if she didn’t stay on something.
  4. Was not able to get into a treatment program until 7 months gestation due to long wait lists. Now on Suboxone MAT w/out any unprescribed opiates or heroin. No other exposures present.
  5. Last assessment was approximately 3-4 hours ago.
  6. At that time, baby exclusively breastfeeding with good latch. Fed 10 times in past 24 hours. Weight down 2%; 2 voids and stools each in past day.
  7. Mom rooming-in with baby & keeping room calm/quiet. No visitors present.
  8. Baby was sleeping well & consoling within a few minutes with skin-to-skin contact. Was a little jittery and fussy with diaper change, but calmed with holding.

In-room Assessment

  1. Breastfed well x 20 min. Took only a few minutes to latch. Mom w/ some mild nipple pain, but baby content. Baby fell asleep after feeding.
  2. Awake again in ~1-1.5 hours, cueing to feed.
  3. Fussy but able to console within 3-5 minutes with skin-to-skin contact.
  4. Latched within few min after calming & breastfed x 30 min total. Was a little sleepy during feeding but would start nursing again when mom stimulated her.
  5. Content and calm after a feeding in mom’s arms. Mom called out to RN to assess baby at this time as instructed by last shift’s RN.
  6. Baby with mild tremors and fussiness on exam but calms when picked up. Tone and Moro are normal. Vital signs are stable. No other symptoms of withdrawal noted.
  7. Mom is worried that baby may feel badly as he withdraws from her Suboxone as she knows this is very uncomfortable from her own personal experience so is holding baby all of the time.
  8. In review of non-pharmacologic care interventions (NPIs) currently being used, mom shares that she doesn’t know how to swaddle her baby, and has not yet learned about rhythmic movement.

Written Case 1 Rating Sheet

Written Case 1 Baseline IRR Assessment

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