Inpatient Obstetric Nurse (NCC) Practice Exam 2026 - Free NCC Practice Questions and Study Guide

Bag and mask ventilation should be avoided in babies with congenital diaphragmatic hernia primarily because air can be forced into the intestine. In congenital diaphragmatic hernia, there is an abnormal opening in the diaphragm, allowing abdominal organs to move into the thoracic cavity. When positive pressure ventilation is applied, such as with a bag and mask, it can inadvertently inflate the gastrointestinal tract rather than the lungs. This inflation of the intestines can lead to further respiratory distress and complications, such as worsening the patient's condition due to increased intra-abdominal pressure, which can impede lung expansion and function.

This is especially important to consider in these neonates who may already be compromised due to the displacement of the lungs and mediastinal structures. Understanding this mechanism emphasizes the need for alternative ventilation strategies that do not involve forcing air into the gastrointestinal system, thus helping to manage these patients more effectively during resuscitation and stabilization efforts.