A newborn has meconium aspiration at birth. The nurse notes increasing respiratory distress. What action takes priority?
Obtain an oxygen saturation.
Stimulate the baby to increase respirations.
Prepare to initiate ECMO.
Notify the provider at once.
The Correct Answer is D
Choice A) Obtain an oxygen saturation: This is not a priority action because it does not address the underlying cause of the respiratory distress, which is meconium aspiration. Meconium aspiration can cause airway obstruction, inflammation, infection, and pulmonary hypertension in the newborn. Oxygen saturation may be low, but it is not a reliable indicator of the severity of the condition.
Choice B) Stimulate the baby to increase respirations: This is not a priority action because it may worsen the respiratory distress by increasing the work of breathing and causing more meconium to be aspirated. Stimulation may also cause stress and hypoxia in the newborn.
Choice C) Prepare to initiate ECMO: This is not a priority action because it is a last resort treatment for severe cases of meconium aspiration syndrome that do not respond to conventional therapies. ECMO stands for extracorporeal membrane oxygenation, which is a form of life support that bypasses the lungs and provides oxygen to the blood.
ECMO has many risks and complications, such as bleeding, infection, and organ damage. It should only be used when other options have failed and with the consent of the parents.
Choice D) Notify the provider at once: This is the correct action because it allows for prompt assessment and intervention by the provider, who can initiate appropriate treatments for meconium aspiration syndrome. These may include suctioning of the airway, administration of antibiotics, surfactant, or inhaled nitric oxide, and mechanical ventilation . Early treatment can improve the outcomes and reduce the complications of meconium aspiration syndrome.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A) Missed abortion: This is not the correct obstetric complication for methotrexate treatment. A missed abortion is a type of miscarriage in which the fetus has died but the products of conception are still retained in the uterus. Methotrexate is not used for this condition, as it can cause toxicity and bleeding. The usual treatment options for a missed abortion are expectant management, medical induction, or surgical evacuation.
Choice B) Abruptio placentae: This is not the correct obstetric complication for methotrexate treatment. Abruptio placentae is a condition in which the placenta separates from the uterine wall before delivery, causing bleeding and fetal distress. Methotrexate is not used for this condition, as it can worsen the bleeding and harm the fetus. The usual treatment options for abruptio placentae depend on the severity of the condition and the gestational age, but they may include fluid resuscitation, blood transfusion, tocolysis, or emergency delivery.
Choice C) Unruptured ectopic pregnancy: This is the correct obstetric complication for methotrexate treatment. An ectopic pregnancy is a pregnancy that implants outside of the uterine cavity, usually in the fallopian tube. An unruptured ectopic pregnancy is one that has not caused any bleeding or rupture of the tube. Methotrexate is used for this condition, as it can dissolve the pregnancy tissue and prevent further growth and complications.
Methotrexate is given as an injection and works by inhibiting folic acid metabolism, which is essential for cell division.
Methotrexate is only suitable for patients who have stable vital signs, low levels of human chorionic gonadotropin (hCG), and no fetal heartbeat or cardiac activity detected by ultrasound.
Choice D) Complete hydatidiform mole: This is not the correct obstetric complication for methotrexate treatment. A complete hydatidiform mole is a type of gestational trophoblastic disease in which there is an abnormal proliferation of placental tissue without any fetal development. Methotrexate is not used for this condition, as it can cause resistance and recurrence. The usual treatment option for a complete hydatidiform mole is suction curettage, which removes the molar tissue from the uterus.
Correct Answer is D
Explanation
Choice a) We are protecting the infant from our bacteria is incorrect because this is not the main reason why gloves are needed when handling a newborn. While it is true that newborns have immature immune systems and are susceptible to infections, gloves are not only used to protect the infant from our bacteria but also to protect ourselves from the infant's body fluids and secretions, which may contain pathogens or blood-borne diseases.
Therefore, this response is incomplete and misleading.
Choice b) Amniotic fluid and maternal blood pose risks to us is incorrect because this is also not the primary reason why gloves are needed when handling a newborn. While it is true that amniotic fluid and maternal blood may contain harmful microorganisms or viruses that can infect us, gloves are not only used to protect ourselves from these substances but also to protect the infant from our skin flora and potential contaminants, which may cause skin irritation or infection. Therefore, this response is also incomplete and misleading.
Choice c) It is hospital policy is incorrect because this is not a sufficient or satisfactory reason why gloves are needed when handling a newborn. While it is true that wearing gloves may be a hospital policy or protocol, this response does not explain the rationale or evidence behind this policy and may imply that the nurse does not understand or agree with it. Therefore, this response is vague and unprofessional.
Choice d) It is part of standard precautions is correct because this is the best and most accurate reason why gloves are needed when handling a newborn. Standard precautions are a set of guidelines and practices that aim to prevent the transmission of infections in healthcare settings. They include wearing gloves, gowns, masks, and eye protection when there is a risk of exposure to blood or body fluids, as well as washing hands before and after patient contact, cleaning and disinfecting equipment and surfaces, and disposing of waste properly. Standard precautions apply to all patients, regardless of their diagnosis or infection status, and are based on the principle that all blood and body fluids are potentially infectious. Therefore, this response is clear and appropriate.
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