Administration of glucocorticoid before delivery and

Administration of glucocorticoid before delivery and surfactant administration postnatally
Nursing Care Management for RDS
1. Promoting adequate gas exchange
2. Promoting adequate nutrition and hydration
3. Maintaining thermoregulation
4. Encouraging parental attachment
5. Family education and health management
6. Have emergency equipment readily available for use in the event of cardiac or respiratory arrest
7. Institute cardiorespiratory monitoring to continously monitor heart and RR
8. Administer supplemental O2
9. Assist with ET intubation and maintain mechanical ventilation as indicated
10. Measure O2 concentration every hour and record
11. Monitor ABG levels as appropriate
12. Institute pulse oximetry
13. Observe the infant’s response to oxygen
• Observe for improvement in color, respiratory rate and pattern and nasal flaring

• Note a response by improvement in arterial or capillary blood gas levels Observe closely for
apnea
• Stimulate infant if apnea occurs. If unable to produce spontaneous respiration with stimulation
within 15-30 seconds, initiate resuscitation
• Position the infant to allow for maximal lung expansion
• Prone position provides for a larger lung volume, decreases energy expenditure and increase
the time spent in quiet sleep
• Change position frequently
• Stimulate infant if apnea occurs. If unable to produce spontaneous respiration with stimulation
within 15-30 seconds, initiate resuscitation
• Position the infant to allow for maximal lung expansion
• Prone position provides for a larger lung volume, decreases energy expenditure and increase
the time spent in quiet sleep
• Change position frequently
• Suction as needed because the gag reflex is weak and cough is ineffective
• Try to minimize time spent on procedures and interventions and monitor effects on respiratory
status
• The decision to suction should be based on assessment of the infant such as auscultation of
the chest,decrease in Oxygenation, excessive moisture in the ET tube and irritability
A. Nasopharyngeal, tracheal or ET tube suctioning should be done gently, quickly, 5
seconds or less with intermittent suction applied as the catheter is withdrawn
B. To prevent hypoxemia, observe oximeter before, during and after the procedure
C. Suctioning of the ET tube is done to maintain a patent airway. The practice of inducing a
catheter into the tube until resistance is met, and then withdrawn has been known to
cause trauma to the tracheal wall.Instead the catheter should be premeasured according
to the size of the infant’s ET tube length and documented. When suctioning, do not insert
the catheter beyond this predetermined length to prevent damage to the mucosa
• Observe for complications of suctioning: bronchospasm, vagal nerve stimulation, bradycardia,
hypoxia, increased intracranial pressure, trauma to airway, infection and pneumothoraces
• VLBW and extremely low birth weight neonates cannot tolerate percussion and vibration. T-
burg position is contraindicated in premature neonates and may result in increased