Neonatal Nurse Practitioner Practice Exam

A newborn shows signs of respiratory distress and has an arterial blood gas that indicates hypoxemia and hypercapnia. What is a likely initial therapeutic approach?

1. Increasing oxygen concentration

2. Reducing ventilatory pressure

3. Administering diuretics

4. Starting intravenous fluids

The correct answer is: Increasing oxygen concentration

Increasing oxygen concentration is a critical initial therapeutic approach for a newborn displaying signs of respiratory distress with arterial blood gas results indicating hypoxemia and hypercapnia. Hypoxemia refers to low levels of oxygen in the blood, while hypercapnia indicates elevated levels of carbon dioxide. The primary goal in such situations is to improve oxygenation and alleviate respiratory distress. When a newborn has low oxygen levels, supplemental oxygen can help increase the amount of oxygen available for the child, enhancing the overall oxygen saturation and supporting vital organ function. The airway may also need to be assessed for potential obstructions or other contributing factors to respiratory distress. In cases of respiratory distress linked to hypoxemia and hypercapnia, simply managing ventilatory pressure or using diuretics wouldn't address the immediate need for oxygenation. While intravenous fluids may be necessary in certain situations to maintain hydration or electrolyte balance, they do not directly resolve the critical issue of inadequate oxygen levels in the blood. Therefore, the most appropriate and effective initial intervention is to increase the concentration of oxygen provided to the newborn.