The nurse is caring for a neonate with a suspected tracheoesophageal fistula (TEF). Nursing care should include which of the following?
Elevating the head but give nothing by mouth
Elevating the head for feedings
Avoiding suction unless infant is cyanotic
Feeding glucose water only
The Correct Answer is A
When caring for a neonate with a suspected tracheoesophageal fistula (TEF), nursing care should include elevating the head but giving nothing by mouth. Tracheoesophageal fistula is a condition where an abnormal connection exists between the trachea and oesophagus, leading to the passage of air and secretions between these structures. Feeding the infant orally can result in aspiration of feedings into the lungs, which can cause respiratory distress and complications. Therefore, it is important to keep the neonate in an upright position to reduce the risk of aspiration until a definitive diagnosis and treatment plan are established.
elevating the head for feedings in (option B), is not appropriate in this case as oral feedings should be avoided until the tracheoesophageal fistula is addressed.
avoiding suction unless the infant is cyanotic in (option C), is not correct. Suctioning may be necessary in neonates with suspected tracheoesophageal fistula to clear secretions and maintain a patent airway.
feeding glucose water only in (option D), is not an appropriate intervention for a neonate with a suspected tracheoesophageal fistula. In this situation, all oral feedings should be withheld until further evaluation and management.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Intussusception is a medical condition where a portion of the intestine telescopes into an adjacent section, causing an obstruction. This obstruction can affect the normal passage of stool through the intestine.
In intussusception, the obstructed intestine can lead to the development of blood and mucus within the stool, giving it a characteristic appearance described as "currant jelly." The stool may contain a combination of blood, mucus, and faecal matter, resembling the colour and consistency of currant jelly.
loose, foul-smelling stools in (option) is incorrect because it, is not specific to intussusception and can be associated with various gastrointestinal conditions.
hard stools positive for guaiac in (option C) is incorrect because it, is not typical of intussusception. Hard stools and positive guaiac test results are more commonly associated with constipation or other conditions affecting the lower gastrointestinal tract.
ribbon-like stools, in (option D) is incorrect because it may be seen in conditions like colorectal cancer or other obstructive disorders. However, it is not a specific characteristic of intussusception.
In the context of intussusception, the presence of "currant jelly" stools is considered a significant sign and should prompt immediate medical attention. Intussusception is a medical emergency and requires prompt diagnosis and treatment.
Correct Answer is C
Explanation
When caring for a child with an open fracture, the nurse should carefully assess for signs and symptoms of infection. An open fracture refers to a fracture where the bone is exposed through the skin, creating a direct pathway for microorganisms to enter and cause infection. Infection is a significant concern in open fractures and can lead to serious complications if not identified and treated promptly. Signs of infection may include increased pain, swelling, redness, warmth, purulent drainage, fever, or systemic signs of infection such as elevated white blood cell count.
Osteoarthritis in (option A) is incorrect because it, is not an immediate concern in the care of a child with an open fracture. Osteoarthritis refers to degenerative joint disease that typically develops over time and is not directly related to the acute management of an open fracture.
epiphyseal disruption in (option B) is incorrect because it, refers to an injury involving the growth plate (epiphyseal plate) that can affect bone growth and development. While it is a potential concern in fractures that involve the growth plate, it is not specific to open fractures and may not be an immediate priority in the initial assessment of an open fracture.
periosteum thickening in (option D) is incorrect because it, may occur in response to injury and fracture healing, but it is not specifically associated with open fractures and is not a primary focus in the initial assessment of an open fracture.
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