The nurse is caring for a neonate with a suspected tracheoesophageal fistula. What should nursing care include?
a. Feed glucose water only.
b. Elevate the patient's head for feedings.
c. Raise the patient's head and give nothing by mouth.
d. Avoid suctioning unless the infant is cyanotic.
ANS: C
When a newborn is suspected of having a 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. The oral pharynx should be kept clear of secretions by oral suctioning. This is to prevent the cyanosis that is usually the result of laryngospasm caused by overflow of saliva into the larynx.
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