2025-10-23·9 min read·Maternal Health
Neonatal Complications for the NCLEX: RDS, NEC, and Hyperbilirubinemia
Common neonatal complications including respiratory distress syndrome, NEC, and jaundice management.
Respiratory Distress Syndrome (RDS)
- Caused by surfactant deficiency - primarily affects preterm infants <35 weeks
- Signs: tachypnea, nasal flaring, intercostal retractions, grunting, cyanosis
- Treatment: surfactant replacement therapy (via ET tube), CPAP or mechanical ventilation, oxygen
- Prevention: antenatal corticosteroids (betamethasone) when preterm delivery is anticipated
Necrotizing Enterocolitis (NEC)
- Inflammation and necrosis of intestinal tissue - most common GI emergency in neonates
- Signs: abdominal distension, bloody stools, feeding intolerance, bilious emesis
- X-ray: pneumatosis intestinalis (air in bowel wall)
- Treatment: NPO, NG decompression, IV antibiotics, TPN. Surgery if perforation
- Prevention: breast milk (protective factor)
Hyperbilirubinemia (Jaundice)
- Physiologic: Appears after 24 hours, peaks at 3-5 days. Common, usually benign
- Pathologic: Appears within first 24 hours - indicates hemolytic process. Requires immediate evaluation
- Treatment: phototherapy (blue light), adequate hydration, monitor bilirubin levels
- Complication: kernicterus (bilirubin deposits in brain) - neurological damage
Review Maternal-Newborn cheat sheet and Newborn Assessment deep dive.