Nursing Student
New Grad

12.09 Lung Surfactant

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  1. Given to premature newborns or sometimes term babies if in respiratory distress
  2. Keeps lungs open and prevents collapse

Nursing Points


  1. Lung surfactant makes it easier for lungs to expand fully
  2. This helps O2 to get into the alveoli and therefore into blood/circulation easier
  3. Given via intubation (ETT) of newborn


  1. Signs of respiratory distress
  2. After administration→ Improved work of breathing and improvement on oxygen saturation

Therapeutic Management

  1. Assist provider with intubation
  2. Secure tube
  3. Administer medication
  4. Assess ABG
  5. Monitor EKG and oxygen levels
  6. Assess vitals
    1. Bradycardia and hypoxia can occur during administration

Nursing Concepts

  1. Pharmacology
  2. Oxygenation

Patient Education

  1. What is is used for
  2. What is expected from it

**DISCLAIMER – In the lesson, the video states that lung surfactant is located in the pleural space, which is incorrect. The correct information is that lung surfactant is made in type II alveolar cells in the alveoli. Both surfactant and pleural fluid work to decrease surface tension.

Reference Links

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Video Transcript

In this lesson I am going to help you understand the importance of lung surfactant and your role in using this in care.

Alright let’s dive right in to what lung surfactant does. So the role is to keep the lungs open and prevent them from collapsing. As you can see in this image where the pleural space or cavity it. This is where the surfactant is and it is going to help keep the lung stuck to the wall of the thoracic cavity. So when the ribs expand the lung will also expand with it. If there isn’t surfactant then the ribs move and the lungs don’t so they collapse. So who would need this? Well any baby that would be at risk for this. So our premature newborns because their lungs aren’t fully developed. If you remember from previous lessons the lungs are not considered to be developed until 35 weeks gestation. Also even a term baby can be born in respiratory distress. So a baby showing us difficulty and grunting or retracting might need some surfactant because they are showing us their their lungs aren’t functioning properly and they need help.

On assessment this newborn will have respiratory distress and low oxygen saturation. So once the decision is made to give it our management will be to assist the provider in intubation if it is not already done and this medication is given down the ET tube. Then assessment will be to see if improvement in work of breathing has occurred as well as blood gases and oxygen saturation assessment. And we will educate the parents on the need for this and what it will hopefully do for their baby.

Pharmacology is a concept because it is medication and this is going to help with oxygenation.

Ok let’s review all this information. So first surfactant reduces the surface tension and lines the alveoli which will keeps the lungs from collapsing. Premature babies do not have enough lung surfactant because their lungs aren’t fully developed so sometimes they require surfactant be given to them and also even some term babies that have respiratory distress.

Make sure you check out the resources attached to this lesson and review the key points. Now, go out and be your best selves today. And, as always, happy nursing.

  • Question 1 of 5

The nurse is caring for a client who is in active labor at 33 weeks’ gestation. The nurse knows that fetal lung maturity is usually present at a minimum of which of the following weeks’ gestation?

  • Question 2 of 5

The nurse knows the role of surfactant is for which one of the following purposes?

  • Question 3 of 5

The nurse administers surfactant to the client and knows it has been successful when the nurse observes which of the following clinical signs?

  • Question 4 of 5

The nurse is caring for a neonate with an order to receive surfactant. The nurse’s role will include which of the following? Select all that apply.

  • Question 5 of 5

The nurse is caring for a newborn who needs surfactant. The nurse knows that which of the following could occur if the newborn does not receive this?

Module 0 – OB Course Introduction

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