A newborn, 48 hours old, exposed to opioids in utero, exhibits irritability, a high-pitched cry, frequent yawning, and vomiting after feeds. The nurse implements non-pharmacologic interventions, but symptoms persist. Which next step is most appropriate?

Rationale: A. Administering ordered morphine as part of a Neonatal Abstinence Syndrome (NAS) protocol is appropriate when non-pharmacologic interventions (such as swaddling, low-stimulation environment, and frequent small feeds) are insufficient to manage withdrawal symptoms. This helps reduce the severity of withdrawal, prevents complications, and promotes adequate feeding and growth. B. Increasing environmental stimulation would likely worsen the newborn’s irritability and is contraindicated in NAS. C. Delaying intervention until withdrawal peaks risks the newborn experiencing unnecessary distress and potential complications such as dehydration or failure to thrive. D. Continuing only non-pharmacologic care for another 24 hours is insufficient if symptoms persist and the infant is not consolable; pharmacologic management is indicated at this stage.