A neonate is admitted to the neonatal intensive
care unit for observation with a diagnosis of
probable meconium aspiration syndrome (MAS).
The neonate weighs 10 lb, 4 oz (4,650 g) and is at
41 weeks’ gestation. Which of the following nursing
diagnoses would be the priority for this neonate?
■ 1. Impaired skin integrity related to post-term
status.
■ 2. Imbalanced nutrition: More than body
requirements related to large size.
■ 3. Risk for impaired parent-infant-child attachment
related to transfer to the intensive care
unit.
■ 4. Impaired gas exchange related to the effects
of respiratory distress.
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The priority nursing diagnosis for the neonate
with probable MAS is Impaired gas exchange
related to the effects of respiratory distress. Obstruction
of the airways may be complete or partial.
Meconium aspiration may lead to pneumonia or
pneumothorax. Establishing adequate respirations
is the primary goal. Impaired skin integrity related
to post-term status is a concern, but establishing and
maintaining an airway and gas exchange is always the
priority. Although nutrition may be altered, oxygenation
takes priority over nutrition. If the parents do
not express interest or concern for the neonate, then
Risk for impaired parent-infant-child attachment may
be appropriate once the airway is established.