Question

During the assessment of a 2-day-old infant born at 32 weeks gestation, the following data is available: HR 122 BPM, RR 50 br/min, irregular with frequent periods of apnea lasting 15-25 seconds, SPO2 86-91%. Which of the following should the respiratory therapist recommend?

a) Increase ventilator rate
b) Administer surfactant
c) Initiate continuous positive airway pressure (CPAP)
d) Administer inhaled nitric oxide

Answer 1

The recommended action for a 2-day-old premature infant with irregular respiration and suboptimal SPO2 levels is to initiate continuous positive airway pressure (CPAP) to stabilize breathing and improve oxygenation.

Step-by-step explanation:

Considering the symptoms of the 2-day-old premature infant born at 32 weeks gestation, with an irregular respiratory rate and periods of apnea, alongside an SPO2 level that is lower than normal, the recommended action would be to initiate continuous positive airway pressure (CPAP). CPAP can help to stabilize the infant's breathing pattern, support spontaneous breathing efforts, and maintain lung volume to improve oxygenation. Since the infant is already being monitored, which suggests the presence of necessary equipment, and given that the infant is already breathing spontaneously but with difficulty, CPAP seems to be the most appropriate initial step. If CPAP is not sufficient, additional interventions, such as surfactant therapy or mechanical ventilation adjustment, could be considered. It is critical to continually assess the infant's condition and adapt the treatment approach as per the evolving clinical scenario and specific medical guidelines.