A nurse is caring for a newborn immediately after delivery. Which action should the nurse prioritize first to ensure the newborn's safety and prevent complications?

Upon delivery, the nurse's immediate priority is to ensure a patent airway and effective breathing. Follow this sequence:

1. Position and Clear Airway: Place the newborn under a radiant warmer, position the head in a neutral or slightly extended 'sniffing' position. Suction the mouth first, then the nares gently with a bulb syringe or suction catheter to prevent aspiration.
2. Stimulate and Assess Breathing: Dry the newborn thoroughly with a warm blanket, which provides tactile stimulation to initiate breathing. Simultaneously, assess respiratory effort, heart rate, and color. If the newborn is crying, it indicates a patent airway and effective breathing.
3. Provide Respiratory Support if Needed: If the newborn is apneic, gasping, or has a heart rate below 100 bpm, initiate positive pressure ventilation (PPV) with a bag-mask device using room air. Ensure a proper mask seal over the mouth and nose.
4. Maintain Warmth and Delay Cord Clamping: Keep the newborn dry and covered to prevent hypothermia. In vigorous newborns, delayed cord clamping for at least 30-60 seconds is recommended to improve iron stores, provided the airway and breathing are stable.
5. Proceed with Routine Care: Once the newborn is stable (breathing well, heart rate over 100 bpm, pink color), proceed with identification bands, vitamin K injection, eye prophylaxis, and anthropometric measurements.

Key Safety Alert: Never suction deep or vigorously, as this can cause vagal stimulation leading to bradycardia. Always have emergency equipment (warmer, oxygen, bag-mask, suction) ready and checked before every delivery.