Medical History
Newborn delivered by repeat cesarean birth at 40 weeks of gestation.
Birth weight 7 lb 12 oz (3,515 g)
Apgar scores 8 at 1 min and 9 at 5 min
Maternal history of methadone use during pregnancy.

Vital Signs
0700:
Heart rate 156/min
Respiratory rate 68/min
Temperature 37.7° C (99.9° F)
Oxygen saturation 97% on room air
1100:
Heart rate 174/min
Respiratory rate 84/min
Temperature 38.2° C (100.8° F)
Oxygen saturation 98% on room air

Physical Examination

1100:
Newborn is inconsolable with a high-pitched cry. Newborn sucks vigorously on pacifier but breastfeeds poorly. Increased muscle tone with moderate to severe tremors when disturbed. Hyperactive Moro reflex noted. Mottled skin noted on extremities. Frequent sneezing. Several loosestools today.

Diagnostic Results
Maternal urine toxicology screen: positive for opiates (negative)
The nurse is planning to contact the provider regarding the newborn's status. Which of the following prescriptions regarding the newborn should the nurse anticipate?
Select all that apply.

1. Instruct the mother to discontinue breastfeeding.
2. Administer scheduled doses of oral morphine.
3. Give a one-time dose of naloxone IM.
4. Maintain a low-stimulus environment.
5.Initiate neonatal abstinence syndrome (NAS) scoring.