Page 829 - Saunders Comprehensive Review For NCLEX-RN

3. Aspiration can occur in utero or with the first breath.

B. Assessment

1. Respiratory distress is present at birth; tachypnea,
cyanosis, retractions, nasal flaring, grunting, crackles,
and rhonchi may be present.
2. The newborn’s nails, skin, and umbilical cord may be
stained a yellow-green color.
C. Interventions

1. If the newborn is delivered in an active, crying

state with no evidence of respiratory distress, no
intervention is necessary.
2. If the newborn is delivered and exhibits inactivity and
lack of cry, endotracheal suctioning is performed. If
the newborn also exhibits lack of respiratory effort
and a low heart rate, additional interventions will be
needed.
3. Newborns with severe meconium aspiration
syndrome may benefit from extracorporeal
membrane oxygenation; this therapy uses a modified
heart-lung machine and provides oxygen to the
circulation, allowing the lungs to rest and decreasing
pulmonary hypertension and hypoxemia.
XII. Bronchopulmonary Dysplasia
A. Description
1. This chronic pulmonary condition affects

newborns who have experienced respiratory failure
or have been oxygen-dependent for more than 28
days.
2. X-ray findings are abnormal, indicating areas of
overinflation and atelectasis.
B. Assessment
1. Tachypnea
2. Tachycardia
3. Retractions
4. Nasal flaring
5. Labored breathing
6. Crackles and decreased air movement
7. Occasional expiratory wheezing
C. Interventions
1. Monitor airway and cardiopulmonary function;
provide oxygen therapy.
2. Fluid restriction may be prescribed.
3. Medications include surfactant at birth,
bronchodilators, and possibly diuretics and

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