Final Answer:
Appropriate nursing actions for the 1-day-old newborn with patent ductus arteriosus (PDA) include:
1. Administering prescribed medications to promote ductal closure.
2. Monitoring oxygen saturation and providing supplemental oxygen if needed.
3. Elevating the head of the bed to facilitate breathing and reduce respiratory distress.
Step-by-step explanation:
1. **Administering Medications:**
The nurse should administer prescribed medications such as indomethacin or ibuprofen, which are commonly used to induce closure of the patent ductus arteriosus in newborns. These medications help constrict the ductus arteriosus and improve cardiovascular function.
2. **Monitoring Oxygen Saturation:**
With an oxygen saturation of 92%, the nurse should closely monitor the newborn's respiratory status. If oxygen saturation drops further or if the newborn shows signs of increased respiratory distress, providing supplemental oxygen is appropriate. Oxygen support helps maintain adequate oxygenation levels, especially if there is evidence of respiratory compromise.
3. **Elevating the Head of the Bed:**
Positioning the newborn with an elevated head of the bed can enhance respiratory mechanics. This position helps reduce the work of breathing and may alleviate retractions and crackles noted in the lungs. Elevating the head supports optimal oxygenation and minimizes respiratory distress.
These nursing actions aim to address the physiological challenges associated with patent ductus arteriosus and respiratory distress in the newborn. Collaborative care with the healthcare team is crucial to ensure the newborn's stability and promote recovery.
Regular assessments, including vital signs and oxygen saturation monitoring, guide the nurse in adjusting interventions based on the newborn's response to treatment.