A newborn delivered at 40 weeks gestation appears cyanotic with poor muscle tone. The heart rate is 80 beats per minute, there is no respiratory effort, and the infant does not respond to stimulation. What is the nurse's priority action?

NRP Algorithm Priority: For a term newborn with apnea, gasping, or heart rate below 100 bpm, initiate positive pressure ventilation (PPV) within the first 60 seconds of life ("The Golden Minute"). The vast majority of newborns respond to effective ventilation alone, as bradycardia is typically a result of myocardial hypoxia from respiratory failure.

Ventilation Technique: Use a self-inflating bag or T-piece resuscitator with an appropriately sized mask. Start with a peak inspiratory pressure of 20-25 cm H2O for term infants. Provide 40-60 breaths per minute while assessing for a rapid rise in heart rate, which is the primary indicator of effective ventilation.

Reassessment Sequence: If the heart rate remains below 100 bpm after 30 seconds of effective PPV, check for chest wall movement and consider the MR. SOPA corrective steps (Mask adjustment, Reposition airway, Suction mouth/nose, Open mouth, Pressure increase, Airway alternative). If heart rate drops below 60 bpm despite effective PPV, initiate chest compressions coordinated with ventilation.

Suctioning Update: Routine tracheal suctioning for non-vigorous newborns born through meconium-stained amniotic fluid is no longer recommended. Airway suctioning should only be performed if the airway appears obstructed or PPV is ineffective; it must not delay the initiation of ventilation.