University:
Northwest College
Course:
VN420 | Child Health
Academic year:

2024
Views:

367

Pages:

2
Author:

Yesenia M.

ESOPHAGEAL ATRESIA AND TRACHEOESOPHAGEAL FISTULA GI anomalies in which the esophagus and trachea don’t separate during embryonic development Esophageal atresia- congenital interrupted esophagus where the proximal and distal ends do not communicate, the upper esophageal segment ends in a blind pouch and the lower segment ends above the diaphragm Tracheoesophageal fistula- abnormal communication between the trachea and esophagus Both defects result in incomplete separation of the lung bed from the foregut during early fetal development Assessment maternal hx of polyhydramnios – this is often the 1st sign of esophageal atresia bc the fetus cannot swallow and absorb amniotic fluid in utero, which leads to accumulation After birth – NB has copious frothy bubbles of mucus in mouth and nose Drooling Abdominal distention as air builds up in stomach Esophageal atresia- GTUBE cannot be inserted bc the esophagus ends in a blind pouch Rattling respirations, excess saliva and drooling if feeding is attempted Fistula increases r/o RR complications such as pneumonitis and atelectasis d/t aspiration Dx: radiograph showing an inserted tube coiled in the upper esophageal pouch or air in the GI tract Nursing management Pre op care NPO Elevate HOB 30-45 degrees to prevent reflux and asporation Monitor hydration status and fluid and electrolye balance- give IVF Assess and maintain patency of orogastric tube Have O2 and suction equipment readily available Assist w dx studies to rule out other d/o Comfort measures- minimize crying to prevent RR distress, provide nonnutritive sucking Document observations Post op care Observe body systems to identify complications Administer TPN and ABX until esophageal anastomosis is proven intact and patent Begin oral feedings within a week after sx