The nurse is called to assist with a 25-year-old G1P0 female with a viable intrauterine pregnancy at 40-weeks gestational age. Patient is already in the second stage of labor and quickly delivers a vigorous, healthy infant without complications. The neonate is placed skin-to-skin with mom and latches well to breastfeed but becomes acutely cyanotic after two minutes of eating. Once separated from the breast, the baby begins to cry, and the cyanosis resolves. Which of the following interventions by the nurse is most appropriate?

Question

The nurse is called to assist with a 25-year-old G1P0 female with a viable intrauterine pregnancy at 40-weeks gestational age.  Patient is already in the second stage of labor and quickly delivers a vigorous, healthy infant without complications. The neonate is placed skin-to-skin with mom and latches well to breastfeed but becomes acutely cyanotic after two minutes of eating. Once separated from the breast, the baby begins to cry, and the cyanosis resolves. Which of the following interventions by the nurse is most appropriate?

Accepted Answer

Attempt to pass a nasogastric tube. Babies are obligate nose-breathers.  If the nasal passages are blocked, then cyanosis will occur while feeding. A quick test to determine the patency of the baby&rsquo;s nasal passages is to attempt to pass a nasogastric tube through each naris. Although the child will likely need some form of respiratory intervention, blow-by oxygen and preparation for impending respiratory failure are not indicated at this time. Bowel sounds in the patient&rsquo;s chest is an indication of congenital diaphragmatic hernia, but the baby&rsquo;s condition would deteriorate with crying rather than improve.

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