Which of the following is incorrect regarding surfactant therapy?

NORCET-7 Mains-2024

Child Health Nursing (Pediatrics)

Easy

Appeared in: NORCET-7 Mains-2024

Explanation

The statement that immediate surfactant therapy is given before delivery is factually incorrect.
Surfactant is a liquid medication administered directly into the neonate's lungs via an endotracheal tube, a procedure that can only be performed after birth.
The primary intervention given before delivery to prevent RDS is antenatal corticosteroids (e.g., betamethasone) administered to the mother. These steroids cross the placenta and accelerate fetal lung maturation and surfactant production.
Therefore, confusing prenatal corticosteroid therapy with postnatal surfactant therapy is a critical error.

Option A: This is a correct statement. Surfactant replacement is the primary and standard treatment for RDS in premature infants, which is caused by surfactant deficiency.
Option B: This is a correct statement. Prophylactic surfactant therapy is indicated for extremely premature infants (typically <28 weeks gestation) at high risk for RDS, administered shortly after birth.
Option D: This is a correct statement. All surfactant therapy, whether prophylactic or rescue, is administered after delivery. The term 'intermediate' refers to a post-delivery timeframe.

Visual 1: Diagram - A diagram illustrating the administration of exogenous surfactant through an endotracheal tube into the lungs of a neonate. This would visually reinforce that the procedure is postnatal.
Visual 2: Flowchart - A flowchart differentiating between prenatal and postnatal management of potential RDS. The prenatal path would show maternal administration of corticosteroids, while the postnatal path would show infant assessment and potential administration of surfactant.

Clinical Relevance

Nursing practice connection: Knowing The question tests the knowledge of the principles, timing, and indications of surfactant therapy for neonatal Respiratory Distress Syndrome (RDS) helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
A nurse must clearly understand the difference between antenatal (before birth) and postnatal (after birth) treatments. Confusing maternal corticosteroid administration with neonatal surfactant therapy could lead to critical errors in communication and care planning.
The nurse's role in surfactant administration includes preparing the medication, assisting with the procedure, closely monitoring the infant for adverse reactions (like bradycardia or desaturation), and managing ventilator settings post-administration.
What if? If a 30-week gestation infant develops signs of RDS two hours after birth, the correct action would be 'rescue' surfactant therapy, not prophylactic. The key is that therapy is initiated after symptoms of RDS appear, as opposed to being given immediately at birth based on gestational age alone.

How to Approach the Question

First, identify the core concept: surfactant therapy for neonatal RDS.
Second, recognize the negative framing of the question, which asks for the 'incorrect' statement. This means three of the options will be true, and one will be false.
Third, evaluate each option based on your knowledge of neonatal care. Consider the timing (before vs. after birth), indication (prophylaxis vs. treatment), and patient (mother vs. infant).
Option A: Is surfactant used for RDS? Yes, this is its primary use.
Option B: Is prophylaxis used for <28 week infants? Yes, this is a standard indication.
Option C: Is it given before delivery? No, it's given to the infant after birth. This is a likely candidate for the incorrect statement.

Concept Tested & Keywords

Concept Tested: The question tests the knowledge of the principles, timing, and indications of surfactant therapy for neonatal Respiratory Distress Syndrome (RDS).
Stem keywords: surfactant therapy, incorrect
Lead-in keywords: incorrect
Negative lead-in flag: The question asks for the INCORRECT statement.

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