Question

An infant at 26 weeks of gestation arrives from the delivery room intubated. The nurse weighs the infant, places him under the radiant warmer, and attaches him to the ventilator at the prescribed settings. A pulse oximeter and cardiorespiratory monitor are placed. The pulse oximeter is recording oxygen saturations of 80%. The prescribed saturations are 92%. The nurse's most appropriate action would be to:

a. Listen to breath sounds and ensure the patency of the endotracheal tube, increase oxygen, and notify a physician.
b. Continue to observe and make no changes until the saturations are 75%.
c. Continue with the admission process to ensure that a thorough assessment is completed.
d. Notify the parents that their infant is not doing well.

Answer 1

The most suitable action for the nurse is to check the baby's breath sounds, confirm the proper placement and patency of the endotracheal tube, adjust the oxygen levels as needed, and promptly inform a physician.

Step-by-step explanation:

The nurse's most appropriate action in this scenario where an intubated premature infant, under the radiant warmer with prescribed oxygen saturations of 92% is showing only 80% saturations on the pulse oximeter, would be to: a. Listen to breath sounds and ensure the patency of the endotracheal tube, increase oxygen, and notify a physician.

It is crucial because premature infants often require supplemental oxygen due to immature lung development associated with conditions such as respiratory distress syndrome (RDS). The lungs of a preterm infant may not have produced enough surfactant, which is a substance that prevents alveolar collapse at the end of expiration, and the necessary structures for oxygen exchange may not be fully developed. Hence, mechanical ventilation and oxygen supplementation are critical for maintaining adequate oxygen levels in the bloodstream and preventing hypoxia, which can lead to significant complications or fatal outcomes.