The nurse is attending the delivery of a full-term neonate whose mother received poor prenatal care. The neonate has cyanosis, increased work of breathing, a barrel chest, and a scaphoid abdomen. The nurse auscultates the patient’s lung fields and notes bowel sounds over the left side of the chest. The nurse suspects which condition in this neonate?

Question

The nurse is attending the delivery of a full-term neonate whose mother received poor prenatal care. The neonate has cyanosis, increased work of breathing, a barrel chest, and a scaphoid abdomen. The nurse auscultates the patient&rsquo;s lung fields and notes bowel sounds over the left side of the chest. The nurse suspects which condition in this neonate?

Accepted Answer

Congenital diaphragmatic hernia. The patient&rsquo;s respiratory distress, barrel chest, scaphoid abdomen, and bowel sounds in the chest point to congenital diaphragmatic hernia (CDH). Meconium aspiration syndrome (MAS) occurs when a stressor causes the fetus to expel meconium then breathe it into the lungs with amniotic fluid. CDH and MAS may both cause persistent pulmonary hypertension of the newborn (PPHN), which occurs when the neonate&rsquo;s pulmonary vasculature fails to adapt to extrauterine life, but this is not the primary diagnosis. Transient tachypnea of the newborn occurs when the neonate fails to clear the fluid from the lungs at delivery and is characterized by tachypnea and mild-moderate respiratory distress.

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