NORCET 10 Mains: Lung surfactant in a preterm neonate is administered via which route?

NORCET 10 Mains

Child Health Nursing (Pediatrics)

Easy

Appeared in: NORCET 10 Mains

Explanation

Lung surfactant is administered directly into the trachea to treat Respiratory Distress Syndrome (RDS) in preterm neonates.
This method is known as the intratracheal or endotracheal route, ensuring the medication reaches the alveoli where it is needed.
The primary function of surfactant is to lower surface tension within the alveoli, preventing their collapse during expiration.
Direct delivery to the lungs is essential for this local action, as systemic routes would be ineffective.

Option A: The intravenous route delivers medication into the bloodstream for systemic effect. Surfactant given this way would be diluted and metabolized before reaching the lungs and would not be able to perform its function on the alveolar surface.
Option B: The intramuscular route involves injecting medication into a muscle for absorption into the bloodstream. This is a systemic route and is not suitable for delivering surfactant directly to the lungs.
Option D: The subcutaneous route involves injecting medication into the fatty tissue under the skin for slow absorption into the systemic circulation. It is inappropriate for delivering a medication that needs to act directly and immediately within the lungs.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pharmacology: Route of Administration for Neonatal Lung Surfactant as background academic context rather than a clinical decision trigger.
Nurses play a crucial role in preparing the surfactant, assisting with the administration procedure, and closely monitoring the neonate's vital signs (oxygen saturation, heart rate, respiratory effort) for improvement or adverse reactions like bradycardia or oxygen desaturation.
Positioning the neonate correctly during and after administration is vital to ensure even distribution of the surfactant throughout the lungs.
What if? If the neonate experiences bradycardia and desaturation during administration, the procedure must be paused immediately. The nurse should ensure the neonate is stabilized with appropriate ventilation support before the procedure is resumed by the provider.

How to Approach the Question

First, identify the core of the question: It asks for the administration route of a specific drug (lung surfactant) in a specific population (preterm neonate).
Recall the function of lung surfactant: It works locally inside the alveoli of the lungs to reduce surface tension and prevent collapse.
Apply the principle of drug administration: To achieve a local effect in a specific organ like the lungs, a direct delivery route is most effective and necessary.
Evaluate the given options: Intravenous (IV), Intramuscular (IM), and Subcutaneous (SC) are all systemic routes that distribute the drug throughout the body via the bloodstream.
Identify the only direct route to the lungs among the choices: The intratracheal route delivers the substance directly into the trachea (windpipe) and down to the alveoli.
Conclude that the intratracheal route is the only logical and effective method for administering lung surfactant.

Concept Tested & Keywords

Concept Tested: Pharmacology: Route of Administration for Neonatal Lung Surfactant
Stem keywords: Lung surfactant, preterm neonate, administered, route
Lead-in keywords: which route
Negative lead-in flag: false

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E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 156-158

E6 Obstetrics Williams p. 27-46

E6 Nursing Fundamentals Taylor p. 839-841