An infant has been born with an esophageal atresia and tracheoesophageal fistula. What is a priority preop nursing diagnosis?

1. Risk for aspiration related to regurgitation
2. Acute pain related to esophageal defect
3. Ineffective infant feeding pattern related to uncoordinated suck and swallow
4. Ineffective tissue perfusion: gastrointestinal related to decreased circulation


1
Rationale:
1. Depicted is the most common type of esophageal atresia and tracheoesophageal fistula, where the upper segment of the esophagus ends in a blind pouch and a fistula connects the lower segment to the trachea. Preoperatively, there is a risk of aspiration of gastric secretions from the stomach into the trachea because of the fistula that connects the lower segment of the esophagus to the trachea.
2. Pain usually is not experienced preoperatively with this condition.
3. The infant is always kept NPO preoperatively, so ineffective feeding pattern would not apply.
4. Tissue perfusion is not a problem with this condition.

Nursing

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