Describe how cigarette smoking, marijuana use, binge alcohol consumption, and excessive caffeine intake can affect Nikkis pregnancy

Nikki is 17 years old G1P0 at 33 week’s gestation. Nikki comes to the clinic today for her prenatal visit and you notice that her hair and clothing have the distinct odor of marijuana and tobacco smoke. You directly ask Nikki if she has been taking any other drugs besides marijuana. Nikki is surprised by the question and denies it. When you explain that you can smell it in her hair and her clothing she starts to cry and says, “Please don’t take my baby away from me”. After reassurance, Nikki further admits to sporadic binge alcohol consumption and smoking ‘pot” and cigarette. She relates that she also consumes four to five caffeinated beverage per day.

Describe how cigarette smoking, marijuana use, binge alcohol consumption, and excessive caffeine intake can affect Nikki’s pregnancy
What possible affects are there to Nikki’s baby from maternal ingestion of this substances?
Describe the nursing care you would provide for Nikki