TEF

Data collection

1. Frothy saliva in the mouth and nose; drooling 2. Coughing, choking during feedings, and unexplained syanosis as result of respiratory distress (also called the 3 C's) 3. Regurgitation and vomitin 4. Abdominal distention 5. Inability to pass a smalll-gauge (#5 French) orogastric feeding tube via mouth into stomach.

Preoperative interventions

1. Infant may be placed in incubator or radiant warmer, and humidified O2 administered; intubation and mechanical ventilation may be necessary if respiratory distress occurs. 2. Maintain NPO status 3. Maintain IV fluids; as prescribed 4. Suction accumulated secretions from mouth and pharynx 5. A double-lumen catheter is placed into the upper esophageal pouch and attached to intermittent or continuous low suction to keep the pouch empty of secretions; it is irrigated w/normal saline, to prevent clogging 6. Maintain infant in an upright position to facilitate drainage and to prevent aspiration of gastric secretions. 7. A gastrostomy tube may be placed and is left open so that air entering the stomach through the fistula can escape, thus minimizing the danger of regurgitation 8. Administer broad-spectum antibiotics, because of high risk for aspiration pneumonia.

Description

1. the esophagus terminated before it reaches the stomach, a fistula is present that forms an unnatural connection w/the trachea, or both 2. Condition causes oral intake to enter the lungs or a large amount of air to enter the stomach; choking, coughing, and severe abdominal distention can occur. 3. Aspiration pneumonia and severe respiratory distress will develop, and death will occur without surgical intervention 4. Treatment include maintenance of a patent airway, prevention of pneumonia, gastric or blind-pouch decompression, supportive therapy, and surgical repair.

366 Nurse reviews record of an infant who is seen in clinic. Nurse notes that a diagnosis of esophageal atresia w/tracheoesophageal fistula (TEF) is suspected. Nurse expects to note which most likely clinical manifestation of this condition in the medical record?

Choking w/feedings. R: Any chil who exhibits the 3C's - coughing and choking during feedings and unexplained cyanosis - should be suspected of having TEF-tracheoesophageal fistula.