Infant delivered at 28 weeks gestation by cesarean section is diagnosed with nonimmune hydrops fetalis. Which of the following interventions should the nurse anticipate in management of the infant?

• A. Thoracentesis and/or paracentesis
• B. Vaccination
• C. Full enteral feeding immediately
• D. Dialysis

Answer: (A)

Nonimmune hydrops fetalis results in fluid accumulation in multiple body compartments, leading to respiratory compromise and cardiac strain after birth. The most important immediate nursing intervention is to relieve the fluid buildup that’s enlarging the lungs and impairing ventilation, which is accomplished by procedures such as thoracentesis to drain pleural effusions and paracentesis to remove ascites. By removing these fluids, lung expansion improves and venous return stabilizes, helping the infant breathe more effectively and tolerate subsequent care. Vaccination is not part of the acute management, and giving full enteral feeds right away can worsen respiratory or hemodynamic instability. Dialysis isn’t the initial standard intervention for hydrops unless there’s separate, established renal failure with fluid overload. So the anticipated intervention is thoracentesis and/or paracentesis to relieve effusions and support respiratory and circulatory status.