Answer and Explanation 20

20.  A is the correct answer.  This patient has RDS (Repsiratory Distress Syndrome).  This patient needs immediate administration of Survanta.  Surfactant replacement is essential to decrease mortality and morbidity.  Administering oxygen would be appropriate for transicient tachypnea of the newborn (TTN).  This is not likely in this age group.  Also high FiO2 for a prolonged period of time can cause Reitinopathy of Prematurity (ROP).  Getting a CBG alone is not agressive enoug in this situation.  Nasal CPAP may be beneficial in an older term infant but this baby really needs surfactant.