A labor and delivery nurse is caring for a newborn baby whose mother was a regular cocaine user during the entire pregnancy (prenatal cocaine exposure). The nurse expects the newborn to

  1. present with irritability, trouble sleeping, and a shrill cry.
  2. present with lethargy, poor muscle tone, and inability to cry.
  3. require pharmaceutical support for cocaine withdrawal.
  4. benefit from a regular breastfeeding schedule.
Number 1 is correct.
Rationale: A newborn exposed to cocaine in utero may be irritable, have difficulty sleeping/feeding, have a shrill cry, and be underweight. Most infants exposed to cocaine in utero respond well to additional soothing and swaddling in the first week after birth and do not need pharmacological support. Since cocaine can be found in breast milk, the medical team will need to determine the risk versus benefit of breastfeeding.