What should the nurse do first if neonate begins to gag and turns a dusky color?

The first thing the nurse should do for a neonate that begins to gag and turn to a dusky color is to aspirate the neonate's nose and mouth with a bulb syringe. The neonate in this condition because of poor oxygen supply to the lungs. Using the bulb syringe will help clear the airways of the neonate and the neonate's condition is most likely to improve.

The nurse should also calm the neonate but this is after the airway has been cleared.
If after clearing the airways of the neonate, no improvement is seen, the nurse should notify the physician.
Providing oxygen to the neonate will not be of any good unless the airway has been cleared.