The pediatric nurse examines a neonate and documents that the baby is pink in color when crying but turns bluish when quiet. Which question would be most appropriate to ask the parent?
A.
"Does the baby have trouble when eating?"
B.
"Have your other children had this problem?"
C.
"How many respiratory infections has she had?"
D.
"You don't ever prop her bottle, do you?"
ANS: A
Choanal atresia is a congenital malformation of the nose in which there is blockage of the posterior side of the nose. It often is associated with bony abnormalities and may affect one side or both sides of the nose. A child with bilateral choanal atresia usually displays respiratory problems during development. A newborn who is pink in color when crying, yet turns bluish when quiet should be suspected of having bilateral choanal atresia or another defect impeding the nasal airway. Another sign of this disorder is feeding difficulties and resultant lack of weight gain. Because this is not genetic, asking about other children with the condition is irrelevant. The number of respiratory infections will not give information as to the possible diagnosis. Because of the potential for aspiration, the baby should be fed in a semi-upright to upright position; however, the wording of the question might make the parent feel defensive.
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