Question

Within thirty seconds after birth, an unresponsive and limp newborn is placed on the warmer in the "sniffing" position. The nurse clears the airway, dries, and stimulates the newborn. At 1 minute of life, the newborn has shallow, gasping respirations with a heart rate of 62/min. What action should the nurse take?

1.Administer epinephrine(6%)
2.Begin positive pressure ventilation(33%)
3.Continue stimulating the newborn(40%)
4.Start chest compressions(19%)

Answer 1

At 1 minute after birth, the newborn with a heart rate of 62/min and shallow respirations requires immediate positive pressure ventilation according to the Apgar score criteria. Chest compressions and potential epinephrine administration may follow if the heart rate does not improve. The Apgar score assesses crucial newborn health indicators and guides immediate post-birth care.

Step-by-step explanation:

An unresponsive and limp newborn with shallow, gasping respirations and a heart rate of 62/min at 1 minute after birth requires immediate medical attention. According to the Apgar score criteria, heart rate and respiration are critical indicators of a newborn's condition. A heart rate below 60/min and inadequate respiration signal the need for urgent intervention. In this case, the nurse should begin positive pressure ventilation (option 2). This action helps to inflate the lungs and deliver oxygen to the baby's bloodstream. If the heart rate remains below 60/min after 30 seconds and there is no significant improvement, chest compressions combined with ventilation should be initiated. Administering epinephrine is also considered if the heart rate remains very low after proper ventilation and chest compressions.

Scores from the Apgar test, which assesses skin color, heart rate, reflex, muscle tone, and respiration, are critical in determining the immediate care the newborn requires. A score below 5 is an emergency situation, and the newborn should be resuscitated promptly.