Question A newborn infant is delivered via meconium-stained amniotic fluid. The nurse observes signs of respiratory distress, including tachypnea and cyanosis. What is the priority nursing intervention?
A) Administer oxygen via nasal cannula.
B) Perform suctioning of the newborn’s airways.
C) Initiate chest compressions.
D) Place the newborn in a prone position.
E) Encourage breastfeeding.
Rationale:
Meconium-stained amniotic fluid increases the risk of meconium aspiration syndrome (MAS). Suctioning the newborn’s airways is the priority to prevent airway obstruction due to meconium. Administering oxygen, chest compressions, and positioning changes may be necessary but are secondary to airway clearance in this situation.
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Question A term newborn is diagnosed with meconium aspiration syndrome (MAS). The healthcare provider orders antibiotic therapy. What is the rationale for administering antibiotics in this situation?
A) To treat meconium in the lungs.
B) To prevent pneumonia.
C) To enhance surfactant production.
D) To reduce gastrointestinal motility.
E) To promote weight gain.
Rationale:
Antibiotic therapy is indicated in cases of meconium aspiration syndrome (MAS) to prevent secondary bacterial pneumonia. Meconium in the lungs can lead to infection, and antibiotics help mitigate this risk. Treating meconium directly in the lungs is not achieved with antibiotics, and the focus is on preventing complications such as pneumonia.
Question A newborn with meconium aspiration syndrome (MAS) is admitted to the neonatal intensive care unit (NICU). The nurse notes persistent respiratory distress and decreased oxygen saturation. What intervention should the nurse anticipate for this newborn?
A) Administration of intravenous fluids.
B) Placement on room air.
C) Extracorporeal membrane oxygenation (ECMO) referral.
D) Early discharge to home.
E) Initiating oral feeds.
Rationale:
In severe cases of meconium aspiration syndrome (MAS) with persistent respiratory distress and hypoxia, extracorporeal membrane oxygenation (ECMO) may be considered. This advanced life support technique provides temporary cardiopulmonary support. Intravenous fluids, room air, and oral feeds are important aspects of care but are not the primary interventions for severe respiratory distress in MAS. Early discharge is not appropriate for a newborn with ongoing respiratory issues.
Question A full-term newborn is born with meconium-stained amniotic fluid. The nurse assesses the newborn and notes labored breathing, retractions, and cyanosis. What action should the nurse take first?
A) Administer oxygen via mask.
B) Begin chest compressions.
C) Place the newborn in a supine position.
D) Encourage breastfeeding.
E) Initiate suctioning of the airways.
Rationale:
In the case of meconium-stained amniotic fluid, there is a risk of meconium aspiration syndrome (MAS). Suctioning the airways is the priority to clear any meconium, preventing obstruction and improving respiratory distress. Administering oxygen, chest compressions, positioning changes, and breastfeeding may be necessary, but airway clearance takes precedence in this situation.
Question A newborn is diagnosed with mild meconium aspiration syndrome (MAS). The nurse is educating the parents on the care of their infant. What instruction should the nurse provide to the parents?
A) Administer antibiotics as prescribed.
B) Avoid room air to prevent respiratory distress.
C) Encourage frequent oral feeds.
D) Limit skin-to-skin contact.
E) Keep the infant in a prone position.
Rationale:
For a newborn with mild meconium aspiration syndrome (MAS), oral feeds are encouraged to enhance nutritional support and promote lung maturation. Antibiotics are not typically prescribed for mild cases. Room air is appropriate unless there is severe respiratory distress. Skin-to-skin contact is beneficial, and prone positioning is not recommended.
Question A newborn with meconium aspiration syndrome (MAS) is admitted to the neonatal intensive care unit (NICU). The healthcare team suspects respiratory distress syndrome (RDS) as well. What diagnostic test would be essential to differentiate between MAS and RDS?
A) Chest X-ray.
B) Complete blood count (CBC).
C) Blood gas analysis.
D) Electrocardiogram (ECG).
E) Urinalysis.
Rationale:
A chest X-ray is essential for differentiating between meconium aspiration syndrome (MAS) and respiratory distress syndrome (RDS). MAS is characterized by patchy infiltrates due to meconium in the airways, while RDS shows diffuse ground-glass appearance. CBC, blood gas analysis, ECG, and urinalysis are not specific for distinguishing between these respiratory conditions.
Question A term newborn is born through meconium-stained amniotic fluid, and the nurse observes signs of respiratory distress, including grunting and nasal flaring. What is the priority nursing intervention?
A) Administer oxygen via nasal cannula.
B) Initiate chest compressions.
C) Encourage the mother to breastfeed immediately.
D) Suction the newborn’s airways.
E) Place the newborn in a supine position.
Rationale:
In the case of meconium-stained amniotic fluid, meconium aspiration syndrome (MAS) is a concern. Suctioning the newborn’s airways is crucial to prevent airway obstruction and improve respiratory distress. While oxygen administration and positioning are important, addressing airway clearance through suctioning takes precedence in this situation.
Question A newborn is admitted with meconium aspiration syndrome (MAS). The healthcare provider prescribes antibiotics. What is the rationale behind antibiotic therapy in MAS?
A) To treat meconium in the lungs.
B) To prevent pneumonia.
C) To enhance surfactant production.
D) To reduce gastrointestinal motility.
E) To promote weight gain.
Rationale:
Antibiotic therapy in meconium aspiration syndrome (MAS) is aimed at preventing secondary bacterial pneumonia. While meconium in the lungs is a concern, antibiotics address the risk of infection. Treating meconium directly in the lungs is not achieved with antibiotics, and the focus is on preventing complications such as pneumonia.
Question A newborn with meconium aspiration syndrome (MAS) is receiving treatment in the neonatal intensive care unit (NICU). The nurse observes persistent respiratory distress despite interventions. What intervention should the nurse anticipate for this newborn?
A) Administration of intravenous fluids.
B) Placement on room air.
C) Referral for extracorporeal membrane oxygenation (ECMO).
D) Initiating oral feeds.
E) Early discharge to home.
Rationale:
In severe cases of meconium aspiration syndrome (MAS) with persistent respiratory distress and hypoxia, extracorporeal membrane oxygenation (ECMO) may be considered. This advanced life support technique provides temporary cardiopulmonary support. While other interventions like IV fluids, room air, and oral feeds are important, ECMO is the primary consideration for severe respiratory distress in MAS.
Question A preterm newborn is at risk for meconium aspiration due to prematurity. The nurse is preparing the parents for potential complications. What should the nurse include in the education?
A) Meconium aspiration is more common in term infants.
B) Preterm infants have a lower risk of respiratory distress.
C) Early initiation of oral feeds reduces the risk of meconium aspiration.
D) Antibiotics are not indicated in meconium aspiration syndrome (MAS).
E) Chest X-ray is not necessary for diagnosis in preterm infants.
Rationale:
Meconium aspiration is more commonly associated with term infants, especially those born through meconium-stained amniotic fluid. Preterm infants are at risk for respiratory distress syndrome (RDS) but may also develop meconium aspiration. Early initiation of oral feeds is not a preventive measure, and antibiotics are indicated in MAS cases with signs of infection. Chest X-ray is essential for diagnosis in both term and preterm infants.
