Preterm Neonate and Respiratory Distress Syndrome

Preterm Neonate

• An increased oxygen requirement despite surfactant therapy is the most concerning assessment finding in a 34-week gestation infant with respiratory distress.
• Maintaining a neutral thermal environment to prevent cold stress is the priority nursing goal for a preterm infant placed on a warming table.
• Impaired Gas Exchange related to surfactant deficiency is the most appropriate nursing diagnosis for a premature neonate exhibiting signs of respiratory distress like tachypnea, nasal flaring, and grunting.
• Initiating early feedings with small amounts of breast milk or formula is the priority action to support a preterm infant's growth and development.
• Ineffective Respiratory Function related to immature lung development is the most appropriate nursing diagnosis for a premature neonate showing signs of tachypnea and difficulty feeding.

Respiratory Distress Syndrome (RDS)

• Respiratory rate and effort is the most important initial assessment for a premature infant diagnosed with Respiratory Distress Syndrome (RDS).
• Ensuring adequate oxygenation and respiratory function is the priority goal of care for an infant with RDS.
• A decrease in the infant’s oxygen requirement and stabilization of respiratory rate indicates progress in a preterm infant with RDS.
• Surfactant should be administered into the trachea using an endotracheal tube when giving it to an infant with RDS.
• Monitoring vital signs for respiratory status and oxygenation is the next action to take after administering surfactant to a premature infant with RDS.

Meconium Aspiration Syndrome (MAS)

• Cyanosis and chest retractions are expected signs in a newborn diagnosed with Meconium Aspiration Syndrome (MAS).
• Impaired Gas Exchange related to mechanical obstruction and chemical irritation is the most appropriate nursing diagnosis for a neonate with MAS exhibiting signs of respiratory distress and decreased breath sounds.
• Continuous monitoring of respiratory status and observation for signs of infection is essential when an infant with MAS shows signs of improvement after receiving respiratory support.
• Monitoring oxygen saturation and ensuring adequate oxygenation is the next action.
• Stabilizing respiratory function by providing mechanical ventilation, if necessary, is the priority goal for an infant diagnosed with MAS.

General

• Grunting and nasal flaring indicate that a preterm infant born at 32 weeks gestation may be at high risk for complications related to prematurity.
• Impaired Gas Exchange related to alveolar collapse and surfactant deficiency is the most appropriate nursing diagnosis for an infant with RDS who has an increased work of breathing.
• Assessing the infant’s ability to maintain body temperature without assistance should be the next evaluation to determine the infant’s progress.
• Pre-oxygenating the infant to prevent hypoxia is the priority action to ensure an intubation procedure is safe for a preterm infant.
• Initiating early feeding with small amounts of breast milk or formula is the most important nursing intervention in preventing necrotizing enterocolitis (NEC) in a premature infant.