The nurse is caring for a newborn with a diagnosis of tracheoesophageal fistula (TEF). Which of the following assessment findings may be present in a newborn with TEF? (Select All that Apply.)

Normal feeding and swallowing

Sunken abdomen

Excessive drooling

Respiratory distress

Coughing or choking during feeding

Answer and Explanation

Correct Answer : C,D,E

A.   Normal feeding and swallowing would not be expected in a newborn with TEF, as they typically have difficulty feeding and may choke or cough.
B.   Sunken abdomen is not a typical finding for TEF.
C.   Excessive drooling is a common symptom due to the inability to swallow saliva properly.
D.   Respiratory distress is a hallmark sign of TEF, as the fistula can lead to aspiration and breathing difficulties.
E.   Coughing or choking during feeding is another classic sign of TEF due to the abnormal connection between the esophagus and the trachea.

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Correct Answer is []

Explanation

Potential condition- Intussusception

Intussusception is a condition where one part of the intestine folds into another part, causing an obstruction. It is common in infants and toddlers and typically presents with the following signs- Severe abdominal pain, which causes the child to pull their knees to their chest (classic sign of colicky abdominal pain), red, jelly-like stools (which indicate the presence of blood and mucus in the stool) and palpable mass in the right upper quadrant (which could be the telescoping portion of the bowel).

Actions to Take

Place child on NPO status:

The child should be placed on nothing by mouth (NPO) status to prepare for potential procedures, such as an enema or surgery. This prevents aspiration during any intervention and ensures the bowel is not further irritated by food or liquid intake.

Prepare child for an air enema:

Air enema is a non-invasive treatment for intussusception. It is often used to reduce the telescoping bowel by using air under fluoroscopic guidance. This treatment can resolve the condition in many cases without the need for surgery. The nurse must ensure the child is properly prepared for this procedure (e.g., ensuring the child is NPO, monitoring vitals, and explaining the procedure to the family).

Parameters to Monitor

Stool patterns:

Monitoring the stool patterns is essential to assess the progress and severity of intussusception. The presence of red, jelly-like stools (blood and mucus) is characteristic of intussusception, and any changes in stool appearance can help evaluate the effectiveness of treatment. The nurse should monitor if the stool pattern changes after the air enema or surgical intervention.

Abdominal pain:

Abdominal pain is a hallmark symptom of intussusception, and the nurse should continually assess the child's pain level. The child may experience intermittent, severe cramp-like pain due to the bowel obstruction. Monitoring and managing the pain effectively is crucial for patient comfort and well-being.

A. Promote quiet activities and rest B. Provide liquids with straws C. Closely monitor ABC D. Monitor and treat pain E. Apply ice collar as ordered

Correct Answer is ["A","C","D","E"]

Explanation

A. Quiet activities and rest should be promoted to ensure the child is not overstimulated and to allow for proper recovery.
B. Liquids should be given without straws to avoid potential injury to the surgical site.
C. Monitoring the airway, breathing, and circulation (ABC) is essential, particularly in the first few hours post-surgery.
D. Pain management is critical to ensure the child’s comfort and to help with healing.
E. Applying an ice collar can help reduce swelling and pain after a tonsillectomy.

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The nurse is caring for a newborn with a diagnosis of tracheoesophageal fistula (TEF). Which of the following assessment findings may be present in a newborn with TEF? (Select All that Apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is []

Explanation

Actions to Take

Parameters to Monitor

A nurse is caring for a 5-year-old child who is 3 hours post-operative uncomplicated tonsillectomy. Which of the following actions are appropriate post op care? (SELECT ALL THAT APPLY)

Correct Answer is ["A","C","D","E"]

Explanation

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