Within thirty seconds after birth, an unresponsive and limp newborn is placed on the warmer in the "sniffing" position. The nurse clears the airway, dries, and stimulates the newborn. At 1 minute of life, the newborn has shallow, gasping respirations with a heart rate of 62/min. What action should the nurse take?

Question

Within thirty seconds after birth, an unresponsive and limp newborn is placed on the warmer in the "sniffing" position.  The nurse clears the airway, dries, and stimulates the newborn.  At 1 minute of life, the newborn has shallow, gasping respirations with a heart rate of 62/min.  What action should the nurse take?

Quizplus · Accepted Answer

11ecbb05_cc13_2598_b433_cff40f588713_MD0009_00 Newborns are evaluated immediately after birth for adaptation to extrauterine life. Newborns requiring resuscitative measures should be cared for using structured, evidence-based interventions, such as the neonatal resuscitation program (NRP) algorithm. Each step of the NRP algorithm requires rapid assessment and decision-making at 30-second intervals. NRP dictates that positive pressure ventilation (PPV) be started when a newborn's heart rate is <100/min. Effective PPV will often result in a rising heart rate and return of spontaneous respirations. (Option A) Epinephrine is administered after chest compressions, if the heart rate remains < 60/min. (Option C) The newborn has already been stimulated for 30 seconds, and placed in the optimal "sniffing" position. The next step is initiation of PPV if the heart rate remains <100/min. (Option D) Chest compressions are started after at least 30 seconds of quality PPV, if the newborn's heart rate remains <60/min. The landmark for compressions is the middle third of the sternum just below an imaginary line drawn between the nipples. Either the two-finger, or two-thumb technique may be used for newborn chest compressions. Educational objective: Neonatal resuscitation interventions after birth are initiated at 30-second intervals, with continual assessment of the newborn's adaptation to extrauterine life. Positive pressure ventilation (PPV) is started if heart rate is <100/min; compressions are started if the newborn's heart rate remains <60/min after at least 30 seconds of quality PPV.

Within Thirty Seconds After Birth, an Unresponsive and Limp Newborn