Final answer:
In a preterm infant with continued respiratory distress despite oxygen and ventilation, the nurse should suspect Respiratory Distress Syndrome (RDS), a condition stemming from insufficient pulmonary surfactant production in premature infants.
Step-by-step explanation:
In the continuing assessment of a preterm infant, the nurse notices continued respiratory distress even though oxygen and ventilation have been provided. The most likely diagnosis the nurse should suspect is Respiratory Distress Syndrome (RDS). This condition occurs primarily in infants born prematurely, due to insufficient production of pulmonary surfactant, which is critical for the lungs to function properly at birth. Without adequate surfactant, the infant's lungs struggle to inflate, leading to difficulty in breathing and proper gas exchange. Blood oxygen levels remain low while carbon dioxide levels and pH may be high. As such, despite receiving oxygen and ventilation, the persistence of respiratory distress signs suggests an underlying RDS.
Typical treatment for RDS includes resuscitation and intubation at delivery if spontaneous breathing does not occur, followed by mechanical ventilation. In addition, treatment often involves the administration of pulmonary surfactant, supplemental oxygen, and possibly assisted ventilation using continuous positive airway pressure (CPAP). Furthermore, supportive therapies aiming at temperature regulation and nutritional support, and sometimes antibiotics, are provided to the premature infant.