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Latest revision as of 02:40, 25 September 2026
An infant is born full-term to a 28 year-old G2P1 via repeat cesarean section. The prenatal course and delivery are uneventful. You are called to evaluate the infant three hours after delivery for grunting, nasal flaring, and retractions. Pulse oximetry is 95%. Respiratory rate is 65 breaths per minute and the nurse has deferred enteral feeding. A chest x-ray reveals hyperinflation and fluid-filled fissures. The next step is to:
a) Admit to the NICU for observation
b) Placement of a UVC for anticipated administration of diuretics
c) Intubation and mechanical ventilation
d) Draw blood cultures and obtain an echocardiogram
e) Reassurance only
Answer
Answer a. This case description is consistent with TTN. Although mild cases may warrant only reassurance, based on this infants level of distress (grunting), increased level of monitoring is indicated.
Notes
- This question originally printed in the Pediatric Anesthesiology Review Topics kindle book series, and appears courtesy of Naerthwyn Press, LLC.