Esophageal atresia/Tracheoesophageal fistula

What is it?

Esophagus terminates before reaching the stomach. There is blind pouch. Oral feedings may enter the lungs if fistula present or remain in a blind pouch if only atresia present. Risk for aspiration pneumonia and respiratory distress.

Baby will choke and turn blue with feedings

Symptoms

  • NPO to prevent aspiration
  • IV fluids as prescribed
  • Monitor respiratory status
  • Suction mouth and pharynx
  • At 30 degrees upright
  • Keep pouch empty of secretions
  • Gastrostomy tube
  • Antibiotics as prescribed for pneumonia

Post Surgical Correction Care

  • Monitor respiratory status
  • May have a chest tube
  • Check for anastomosis leak (purulent chest tube output, ↑ WBC, fever)
  • If G tube placed, feed after 5 to 7 days when incisison healed. This baby will be on TPN while NPO.
  • Esophagram to check esophageal anastomosis before feeding
  • Start feeds with sterile water
NCLEX alert: Begin feeds with sterile water
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