A premature neonate is experiencing severe respiratory distress in the delivery room. Once bag/mask ventilation and oxygen are provided, the condition of the infant deteriorates further. The abdomen appears sunken, body temperature is low, cyanotic and nasal flaring are observed. Which action should the nurse prepare for next?
• For premature infants, respiratory distress syndrome can be largely prevented by the administration of synthetic surfactant through an endotracheal tube. The nurse should be prepared to assist the physician with this procedure. Ventilations are pressure-cycled to control the force of the air delivery.
• Pancuronium is a muscle relaxant that may be given during endotracheal intubation and can increase pulmonary blood flow.
• The infant is suctioned before surfactant administration. After administration, the infant’s airway should not be suctioned again for as long as possible to avoid suctioning out the surfactant.
• A possible complication of oxygen therapy in the immature or very ill infant is retinopathy of prematurity or bronchopulmonary dysplasia.