MECONIUM ASPIRATION SYNDROME

Question 1

Is a condition in which a newborn baby inhales meconium into their lungs, either during or before delivery.

Answer 1

MECONIUM ASPIRATION SYNDROME

Question 2

According to some studies, the incidence of MAS is around _% to __% of all births.

Answer 2

5% to 10% of all births

Question 3

Is a thick, sticky, greenish-black substance that makes up the baby’s first feces

Answer 3

meconium

Question 4

In severe cases, meconium aspiration can lead to?

Answer 4

acute respiratory distress syndrome (ARDS)

Question 5

a condition in which the lungs become inflamed and filled with fluid, making it difficult for the baby to breathe.

Answer 5

acute respiratory distress syndrome (ARDS)

Question 6

(4) MAS - What questions should be asked HEALTH HISTORY - During Pregnancy

Answer 6

1. Did the mother have any complications during pregnancy (e.g. gestational diabetes, hypertension)?
2. Did the mother use any substances during pregnancy (e.g. nicotine, alcohol, illicit drugs)?
3. Did the mother experience prolonged rupture of membranes?
4. Did the mother have any infections during pregnancy?

Question 7

(3) MAS - What questions should be asked HEALTH HISTORY - Labor and Delivery

Answer 7

1. Was there any meconium noted in the amniotic fluid?
2. Did the baby have any difficulty during the delivery process?
3. Did the baby require any resuscitation at birth?

Question 8

(4) MAS - What questions should be asked HEALTH HISTORY - Birth

Answer 8

1. What was the gestational age of the baby at birth?
2. What was the birth weight of the baby?
3. What were the baby’s Apgar scores at 1 and 5 minutes?
4. Were any abnormalities noticed during the baby check?

Question 9

(4) MAS - What questions should be asked HEALTH HISTORY - Since Birth

Answer 9

1. Has the baby experienced any respiratory distress or difficulty breathing?
2. Has the baby had any issues with feeding or digestion?
3. Has the baby experienced any seizures or apnea episodes?
4. Has the baby required any interventions or treatment for MAS?

Question 10

MAS SUBJECTIVE DATA

Answer 10

Mother’s report of yellow/green discharge

Question 11

(5) MAS OBJECTIVE DATA

Answer 11

1. Fetal monitor showing a slow or high fetal heart rate.
2. Green-tinged amniotic fluid when bag of water breaks.
3. Low APGAR score.
4. Course and crackly breath sounds on auscultation when the baby is born.
5. Blood gasses can be performed and can show the following results:
   o Low blood pH
   o Low oxygen level
   o Increased carbon dioxide

Question 12

(14) MAS PHYSICAL ASSESSMENT

Answer 12

1. Tachypnea
2. Retractions
3. Nasal Flaring
4. Crackles
5. Grunting
6. The infant’s skin, nails, and umbilical cord may be stained with yellow to green color.
7. Evidence of postmaturity: peeling skin, long fingernails, and decreased vernix.
8. The vernix, umbilical cord, and nails may be meconium-stained, depending on how long the infant has been exposed in utero.
9. In general, nails will become stained after 6 hours and vernix after 12 to 14 hours of exposure.
10. Affected patients typically have respiratory distress with marked tachypnea and cyanosis
11. Reduced pulmonary compliance and use of accessory muscles of respiration are evidenced by intercostal and subcostal retractions and abdominal (paradoxical) breathing, often with grunting and nasal
    flaring.
12. The chest typically appears barrel-shaped, with an increased anterior-posterior diameter caused by overinflation
13. Auscultation reveals rales and rhonchi - immediately after birth.
14. Some patients are asymptomatic at birth and develop worsening signs of respiratory distress as the meconium moves from the large airways into the lower tracheobronchial tree.

Question 13

(3) MAS Diagnostic and Laboratory Tests

Answer 13

1. chest X-ray
2. Blood gas analysis
3. Meconium analysis

Question 14

MAS Diagnostic and Laboratory Tests:
is the most common test used to diagnose MAS. The results will show fluid in your baby’s lungs. Providers may also use blood gas tests to check oxygen and carbon dioxide levels and confirm the diagnosis

Answer 14

chest X-ray

Question 15

MAS Diagnostic and Laboratory Tests:
can help assess the newborn’s respiratory status, including the oxygen and carbon dioxide levels in the blood.

Answer 15

Blood gas analysis

Question 16

MAS Diagnostic and Laboratory Tests:
can confirm the presence of meconium in the lungs and determine the severity of the aspiration. This may be tested for the presence of inflammatory markers and bacteria.

Answer 16

Meconium analysis

Question 17

(3) MAS NURSING DIAGNOSIS PLANNING & IMPLEMENTATION OF CARE Desired outcome

Answer 17

1. The patient will maintain adequate breathing with respiratory rate and oxygen saturation within the normal range
2. Patient will maintain normal core temperature as evidenced by vital signs within normal limits and normal WBC level
3. Patient will be able to maintain fluid volume at a functional level as evidenced by individually adequate urinary output with normal specific gravity, stable vital signs, moist mucous membranes, good skin turgor and prompt capillary refill and resolution of edema.

Question 18

(4) MAS PHARMACOLOGIC THERAPIES

Answer 18

no specific pharmaceutical drugs approved for the treatment of Meconium Aspiration Syndrome (MAS). However, the following medications may be used to manage complications associated with the condition:

1. Antibiotics
2. Surfactant therapy
3. Bronchodilators
4. Inhaled nitric oxide

Question 19

(3) MAS SURGICAL INTERVENTIONS

Answer 19

1. Extracorporeal Membrane Oxygenation (ECMO)
2. Continuous positive airway pressure (CPAP)
3. UMBILICAL CATHETERS

Question 20

NUTRITION SUPPORT IN MECONIUM
ASPIRATION SYNDROME

Answer 20

1. Glucose should be the preferred energy source.
   (a) Offering 3 to 5 mg/kg/day is indicated for glucose oxidation rates of 5 to 6 mg/kg/min.
   (b) Physicians should aim to maintain glucose concentrations within the physiologic range and avoid hyperglycemia.
   (c) Lipids should be offered in amounts up to 20 to 35% of the non-protein calories due to metabolic limitations and lipid clearance.
2. Antioxidants are involved in several immune response phases, such as phagocytosis, cytokine production, cell-mediated responses, and immunoglobulin production
   —-these substances are therefore considered immune nutrients. Vitamin A and Vitamin E are prominent within this group of substances, and maintaining the appropriate levels of these vitamins in plasma and tissue can contribute to an anti-infective response.

Question 21

(5) MAS Complementary and Alternative Therapy

Answer 21

1. The use of a ventilator and inhaled nitric oxide
2. Surfactant or antibiotics
3. Extracorporeal membrane oxygenation (ECMO)
4. A radiant warmer
5. Continuous positive airway pressure (CPAP)