A nurse is contributing to the plan of care for a newborn who is experiencing heroin withdrawal. The nurse should anticipate a prescription for which of the following medications?

A. Methadone: Methadone is a long-acting opioid agonist commonly used in the management of neonatal abstinence syndrome resulting from in utero opioid exposure. It stabilizes withdrawal symptoms by binding to mu-opioid receptors and preventing the abrupt cessation effects that occur after birth. Its longer half-life allows for controlled tapering, reducing autonomic instability, irritability, tremors, and feeding difficulties. B. Meperidine: Meperidine is a short-acting opioid analgesic primarily used for acute pain management and is not recommended for withdrawal treatment. Its metabolite, normeperidine, can accumulate and cause neurotoxicity, including seizures, especially in neonates with immature hepatic and renal function. C. Hydromorphone: Hydromorphone is a potent opioid analgesic used for severe pain but lacks the pharmacokinetic profile required for structured withdrawal therapy. Its shorter duration of action increases the risk of fluctuating serum levels, which may worsen withdrawal instability. It is not part of standard neonatal abstinence syndrome treatment protocols. D. Fentanyl: Fentanyl is a highly potent, short-acting synthetic opioid typically used for anesthesia and severe acute pain. Due to its rapid onset and short duration, it does not provide the steady opioid receptor stimulation required to gradually taper withdrawal symptoms in neonates. Its potency also increases the risk of respiratory depression in this population.