A female neonate has been in respiratory distress since delivery and is unresponsive to oxygen therapy. Endoscopy has confirmed a diagnosis of esophageal atresia and tracheoesophageal fistulae (EA/TEF)
Which of the following explanations should the care team provide to the infant's parents?
A)
"We will have to perform surgery to correct the hole in her throat to make sure that she is able to swallow and breathe normally."
B)
"This problem will require respiratory therapy and supplementary feeding, but it will likely resolve itself over time."
C)
"The biggest risk that your daughter will face until this is fixed is the danger of malnutrition and dehydration."
D)
"The priority in our immediate treatment prior to her surgery will be pain management, as the contents of her stomach can burn her lungs."
Ans:
A
Feedback:
EA/TFE necessitate surgery and preclude both normal respiration and swallowing. Aspiration is the primary immediate risk and the priority for treatment. Although the infant will require respiratory therapy to assist with proper tube placement and ventilator maintenance, the only effective treatment is surgery. Aspiration of feeding (aspiration pneumonia) is a major complication that can occur immediately and can be life threatening. Maintaining an open airway and adequate gas exchange are the priority nursing diagnoses for this infant.
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