Products
Pre-Nursing
Nursing Student
NCLEX Prep
New Grad

Nursing Care Plan for Meconium Aspiration

Print

Pathophysiology

Meconium is the sterile substance that is produced in the baby’s intestines during gestation and is normally passed like a stool for the first few days after birth. When meconium is passed in utero and mixed with amniotic fluid, the baby may inhale, or aspirate, the meconium-stained fluid. Meconium does not usually develop before 34 weeks gestation, so this is usually found in babies born at term. The aspiration of meconium can occur before or during labor and immediately after delivery. This thick meconium can irritate and block the baby’s airway.

Etiology

Physiologic stress on the baby is the normal cause of the passage of meconium in utero. This stress can be caused by maternal hypertension, decreased amount of amniotic fluid, maternal infection, insufficient placenta, fetal hypoxia due to the umbilical cord being wrapped around the neck, or maternal drug use.

Desired Outcome

The patient will maintain adequate breathing  with respiratory rate and oxygen saturation within the normal range

Meconium Aspiration Nursing Care Plan

Subjective Data:

  • Mother’s report of yellow/green discharge

Objective Data:

  • Tachypnea
  • Nasal flaring
  • Retractions
  • Cyanosis
  • Expiratory grunting
  • Yellow-green staining of fingernails or skin
  • Yellow-green urine

Nursing Interventions and Rationales

  • Assess respiratory status
    • Rate
    • Effort (retractions, grunting)
    • Oxygen saturation
    • Auscultate for rales or rhonchi
  Meconium aspiration can result in varying degrees of respiratory distress for the infant  
  • Bulb suction mouth and nose or use endotracheal suction to remove secretions
 

  • The method depends on the severity of aspiration and quality of respirations.
  • The idea is to clear the airway however necessary.
  • Avoid using a finger to clear secretions as it may only push them farther into the airway.

 

  • Administer oxygen via hood or positive pressure
  Maintain oxygen saturation at 90-95%. Mechanical ventilation may be necessary.  
  • Assist with the insertion of umbilical artery catheter
  An umbilical artery catheter will minimize agitation and stress of frequent monitoring of blood pH and blood gases by giving direct access to the umbilical artery.  
  • Administer surfactant therapy and medications as necessary
 

  • Surfactant is often given for replacement and to remove meconium
  • Antibiotics may be given empirically

 

  • Monitor hemoglobin levels
  Hemoglobin level is an indicator of effective oxygen-carrying capacity  
  • Monitor blood pressure
  Worsening blood pressure may indicate pulmonary hypertension or pulmonary air leak syndrome  
  • Monitor for signs of Acute Respiratory Distress Syndrome (Arterial Blood Gases)
  Fluid and meconium in the lungs can initiate an inflammatory process that can lead to severe respiratory distress, requiring mechanical ventilation and other invasive interventions for the newborn.  

References

Create Your Account

Get unlimited access to lessons and study tools

  • Question 1 of 4

The nurse is working in labor and delivery. A client’s water broke and it was stained with meconium. When the baby is born, which of the following are PRIORITY interventions for this newborn to prevent meconium aspiration? Select all that apply.

  • Question 2 of 4

A nurse is performing a newborn assessment and believes there may have been meconium in the amniotic fluid. Which assessment findings would be consistent with this? Select all that apply.

  • Question 3 of 4

The NICU team attends delivery of a term newborn because amniotic fluid has meconium present. After suctioning mouth and nares, the baby is crying vigorously at delivery. What is expected management?

  • Question 4 of 4

A nurse is caring for a pregnant client in labor who had meconium-stained amniotic fluid. What is a priority action for the newborn immediately after birth?

Module 0 – Nursing Care Plans Course Introduction
Module Obstetrics (OB) & Pediatrics (Peds) Care Plans

Customize Your Study

Start a trial to create your first custom study plan now.


Start Trial
[FREE]
[FREE]