NORCET-7 Mains-2024: 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

Surfactant therapy involves the direct instillation of exogenous surfactant into the infant's trachea and lungs.
This procedure can only be performed after the infant is born and an endotracheal tube is in place.
Therefore, the statement that surfactant therapy is given before delivery is factually incorrect.
The standard medical practice to promote fetal lung maturity before delivery is the administration of antenatal corticosteroids to the mother.

Option A: This is a correct statement. Surfactant replacement is the primary and standard treatment for neonatal Respiratory Distress Syndrome (RDS).
Option B: This is a correct statement. Guidelines recommend prophylactic surfactant administration for very high-risk infants, such as those born before 28 weeks of gestation, to prevent the onset of severe RDS.
Option D: This is a correct statement. All forms of surfactant therapy, whether prophylactic or rescue, are administered after the infant has been delivered.

Clinical Relevance

Nursing practice connection: Knowing Principles of Surfactant Therapy in Neonates helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses play a critical role in the safe administration of surfactant, including preparing the medication, ensuring correct patient positioning, monitoring for acute complications like bradycardia or desaturation, and managing the ventilator settings post-administration.
A key nursing responsibility is to avoid suctioning the infant's airway for a specified period (usually 1-2 hours) after surfactant is given to ensure the medication is properly distributed and absorbed in the alveoli.
Patient safety during the procedure is paramount. The nurse must be prepared to respond to adverse reactions, such as reflux of the surfactant into the endotracheal tube or sudden changes in oxygenation.

How to Approach the Question

First, identify that the question asks for the 'incorrect' statement. This means you are looking for the false option among the choices.
Read each option carefully and evaluate its factual accuracy based on your knowledge of neonatal care.
Option A: Recall that RDS is caused by surfactant deficiency. Treating it with surfactant is logical and correct.
Option B: Recall that the most premature infants are at the highest risk for RDS. Prophylactic treatment for this group is a known strategy.
Option C: Consider the route of administration. Surfactant is given into the lungs. Think about whether this is feasible before birth. Contrast this with other prenatal therapies. You should recognize that this is not possible and that corticosteroids are the prenatal therapy used.
Option D: This statement says the therapy is given after delivery. Since you've established it cannot be given before delivery, this statement must be true.

Concept Tested & Keywords

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

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 1089-1091

E6 Obstetrics Williams p. 27-46