A nurse is assisting in the care of a newborn immediately following birth. The nurse notes mucus bubbling out of the newborn's mouth and nose.Which of the following actions should the nurse take first?

When mucus is observed bubbling from a newborn's mouth and nose immediately after birth, the priority nursing action is to clear the airway using the least invasive, safest method first. Suctioning the mouth with a bulb syringe accomplishes this effectively and gently. The mouth is suctioned before the nose (M before N) because suctioning the nose first can stimulate a gasp reflex that causes the infant to aspirate oral secretions. This approach follows the principle of using the least invasive intervention adequate to solve the problem. Performing deep suctioning of the trachea with an endotracheal tube is far too aggressive for simple secretions at the mouth and nose; it is reserved for meconium-stained amniotic fluid with a non-vigorous newborn or significant airway obstruction. Placing the newborn in Trendelenburg position is no longer recommended in newborn resuscitation guidelines and could compromise respiratory effort. Administering saline drops into the nares addresses nasal congestion, not active bubbling secretions, and would not clear the airway effectively. The correct first action is gentle bulb syringe suctioning, which quickly and safely clears the upper airway and allows the newborn to establish effective respirations.