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22 Cards in this Set
- Front
- Back
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Explain the difference between esophageal atresia(EA) and tracheoesphageal fistula(TEF)?
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EA is when the esophagus is divided into two unconnected parts with the upper half ending in a blind pouch.
TEA- is an abnormal attachement between the trachea and esophagus where food and air can be mixed together |
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Classic signs of malformation of the esophagus are the 3 C's, name them?
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Coughing, Choking, Cyanosis
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RED/BOLDED: Name one priority Nsg Dx for an infant with EA/TEF?
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Risk for aspiration r/t EA/TEF
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Why is an infant born with EA/TEF made NP0?
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EA- The food has no where to go
TEF- To prevent aspiration |
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What is the goal of preoperative managment of EZ/TEF?
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Remain free of infection,
be free of pain, promote bonding, prevent aspiration |
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How should the infant with EA/TEF be positioned preoperatively?
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Semi-Fowlers at 30 degrees or better to decrease reflux
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In infants with EA/TEF, what techniques are used to suction the proximal puoch and mouth?
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NG tube to low intermittent suctioning
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What care is provided for cervical esophagostomy- Keep the site covered with ? to absorb saliva. Provide ? care around the site. Monitor for ?
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gauze,
skin-care, infection |
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RED/BOLDED: Why are feeding provided only by gravity and not by pump feeding after EA/TEF repair?
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To prevent injury to repair
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RED/BOLDED: Why is gastrostomy tube jept "open to vent" in the immediate post-op period and after feedings?
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to allow gas and trapped air to escape, which redudes pressure to the anastomosis
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RED/BOLDED: Why is non-nutritive sucking important- It satifies ? needs and provides early training in ? which makes later feeding easier and it provides ? through distraction.
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sucking,
swallowing, comfort |
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Explaing G-tube home care for feedings and site care:
New G-tube: Clean site ? with soap and water. If its crusty you can use 1/2 strength peroxide, and gently rotate the tube on a ? basis. Signs of complication include ? or ? A consult that can be made is to a ? |
daily, daily,
drainage or leakage, enterostomal therapist |
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What is gastroschesis: Herniation of the ? on one side of the umbilical cord, formed during the ? stage and it does not have ? sac covering it.
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intestines, embryonic, peritoneal sac
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How does gastroschesis differ from Omphalocele?
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Gastroschesis is not covered by the peritoneal sac,
and Omphalocele is |
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what is volvulus: intestinal ? or ? of the bowel
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malrotation or twisting
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Which defect gastroschesis or omphalocele is more at risk for developin volvulus and why ?
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Gastrochesis,
its not protected by the peritoneal sac, so it can twist easier |
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Which defvect gastroschesis or omphalocele has a higher mortality rate, and has common complications such as sepsis, intestinal obstruction, and GER?
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Omphalocele
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Immediate management in the delivery room for an infant born with an abdominal wall defect involves protectin the site and providing emotional support to the parents. How are each accomplished?
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Protect with sterile gauze soaked in NSS 0.9%,
Focus on positive aspects of the baby, encourage parents to talk with and touch the baby and hold it if appropriate. |
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RED/BOLDED: Why should radiant warmers be used and what are the indication for fluid requirements with gastroschesis and omphalocele? To maintain stable? Establish IV line to maintain F/E balance at as much as ?-? times maintenance
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temperature,
2-3 times maintenance |
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For small abdominal effects how long may it take to reduce the defect back into the cavity? and for larger defects?
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small- soon after birth
Larger-Usually delayed using the SILO may take a while |
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What do you monitor for post-op at the surgical site?
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Dehiscence, bleeding, redness, warmth, I/O's, etc...
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What should be considered for post-op care of EA/TEF:
? and ? tube should be at bedside, frequent suctioning at the ? length that is specified by the physician's order, Gastrostomy feedings should be done ? and always by ? and open to ? |
Laryngoscope, endotracheal,
catheter, slowly, gravity, vent/air |
