A nurse is caring for a client who had a post-term delivery and notes that the amniotic fluid was stained with meconium.

Which of the following actions should the nurse take first?

This is because newborns with hypoglycemia need to receive adequate nutrition to raise their blood glucose levels and prevent neurologic damage.Early feeding also helps establish breast milk supply for nursing mothers.

Choice B is wrong because feeding the baby only when he cries may delay the intake of glucose and worsen the hypoglycemia.Newborns with hypoglycemia should be fed on demand or at least every 2 to 3 hours.

Choice C is wrong because feeding the baby every 6 hours is too infrequent and may cause prolonged hypoglycemia.Newborns with hypoglycemia should be fed on demand or at least every 2 to 3 hours.

Choice D is wrong because feeding the baby with glucose water may not provide enough calories and nutrients for growth and development.Newborns with hypoglycemia should be fed with breast milk or formula.Glucose water may be used as a temporary measure until breast milk or formula is available.

This is because the infant born through meconium-stained amniotic fluid (MSAF) may have meconium aspiration syndrome (MAS), which is a condition that causes respiratory distress due to the inhalation of meconium into the lungs.The priority action for the nurse is to evaluate the infant’s breathing and circulation and initiate resuscitation if needed.

Choice A is wrong because suctioning the infant’s mouth and nose with a bulb syringe is not recommended unless the infant has obvious meconium in the airway and is not vigorous.Suctioning may cause bradycardia, hypoxia, or airway trauma.

Choice C is wrong because drying and stimulating the infant with a warm towel is part of the initial steps of resuscitation, but it should be done after assessing the infant’s heart rate and respiratory effort.Drying and stimulating may also increase the risk of meconium aspiration if the infant gasps.

Choice D is wrong because clamping and cutting the umbilical cord is not a priority action for an infant with possible MAS.The cord should be clamped and cut after ensuring that the infant is stable and has adequate oxygenation.