A patient in labor is found to have meconium-stained amniotic fluid upon rupture of membranes. At delivery, the nurse finds the infant to have depressed respirations and a heart rate of 80. The nurse anticipates:
1. Delivery of the neonate on its side with head up, to facilitate drainage of secretions.
2. Direct tracheal suctioning by specially trained personnel.
3. Preparation for the immediate use of positive pressure to expand the lungs.
4. Suctioning of the oropharynx when the newborn's head is delivered.
2
Rationale 1: The newborn is not delivered on its side.
Rationale 2: Direct tracheal suctioning by specially trained personnel is recommended for infants who experience absent or depressed respirations, heart rate slower than 80 beats/min, or poor muscle tone.
Rationale 3: Positive pressure is not used to expand the lungs.
Rationale 4: Intrapartum suctioning after the head is delivered is no longer recommended.
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