The nurse is caring for a neonate with a suspected tracheoesophageal fistula. Nursing care should include:
a. Elevating the head but giving nothing by mouth.
b. Elevating the head for feedings.
c. Feeding glucose water only.
d. Avoiding suctioning unless the infant is cyanotic.
ANS: A
When a newborn is suspected of having tracheoesophageal fistula, the most desirable position is supine with the head elevated on an inclined plane of at least 30 degrees. It is imperative that any source of aspiration be removed at once; oral feedings are withheld. Feedings of fluids should not be given to infants suspected of having tracheoesophageal fistulas. The oral pharynx should be kept clear of secretion by oral suctioning. This is to avoid the cyanosis that is usually the result of laryngospasm caused by overflow of saliva into the larynx.
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