Question

The nurse in the newborn nursery is preparing to feed a newborn the first feeding of sterile water. During the feeding, the newborn suddenly begins to cough, choke, and become cyanotic. Based on these symptoms, the nurse might suspect that the newborn has which of the following conditions?

a) Gastroesophageal reflux disease (GERD)
b) Aspiration pneumonia
c) Necrotizing enterocolitis (NEC)
d) Meconium aspiration syndrome

Answer 1

The newborn's symptoms of coughing, choking, and cyanosis suggest meconium aspiration syndrome, where meconium in the lungs can cause airway obstruction, surfactant dysfunction, and increased vulnerability to infections like pneumonia.

Step-by-step explanation:

Based on the symptoms of coughing, choking, and becoming cyanotic during the first feeding, the nurse might suspect that the newborn has aspirated, which could suggest meconium aspiration syndrome (MAS). Aspiration of meconium can lead to labored breathing and is typically a sign of fetal distress. In the case presented, choice d) Meconium aspiration syndrome is the most likely condition the newborn is experiencing, as it can cause the newborn to become cyanotic and experience breathing difficulties immediately after birth.

Meconium aspiration syndrome occurs when a newborn inhales a mixture of meconium and amniotic fluid into the lungs around the time of delivery. The inhalation of meconium can obstruct a newborn's airways, leading to alveolar collapse, interfere with surfactant function by stripping it from the lungs, or cause pulmonary inflammation or hypertension. Moreover, meconium in the lungs makes them more prone to pulmonary infections, such as pneumonia, which is relevant as aspiration pneumonia is another condition cited in the question (choice b). However, the initial event of coughing and choking during the first feeding is more directly associated with aspiration, common in meconium aspiration syndrome.