ADN Test 2 QUESTIONS AND ANSWERS 100% CORRECT

ADN Test 2 QUESTIONS AND ANSWERS 100% CORRECT EA-Manifestations Correct Answer: Failure to pass suction catheter, NG tube at birth Excessive oral secretions, drooling Vomiting (undigested formula) Abdominal distention Airless, scaphoid abdomen (atresia without fistula) Sonorous (seal like bark cough) Choking with feeding R.distress and cyanosis (if secretions aspirated) EA-Patho Correct Answer: Occurs when the proximal end of the esophagus ends in blind pouch; food unable to enter stomach through esophagus. With TEF: Occurs when connection exists between the esophagus and trachea; may result in reflux of gastric juice after feeding(4-5weeks of pregnancy) Food enters lungs, air enters stomach Cause is unknown Can be with or without TEF (tracheoesophageal fistula) No difference in sex and incidence Nearly half born with EA have other congenital defects (cardiac, GI, CNS) Prematurity Low birth weight EA-Preop Correct Answer: Initial repair includes ligation of the fistula and end-to-side anastomosis of the atresia to decrease the severity of stricture formation. G-tube placed Anastomosis, colon interposition, and dilation (expected later) Evaluation and treatment of esophageal motility dysfunction, gastroesophageal reflux, strictures, bronchitis and pneumonia may occur as the child grows EA-Assessment Correct Answer: The infant with TEF is at constant risk of aspiration Assess R.distress immediately after birth Examine for excessive oral secretions, choking, and cyanosis. Difficulty swallowing, regurgitation, vomiting, and unexplained cyanosis after inital feeding of an undiagnosed infant are important findings that requires notification of physician immediately. Measure abdominal distention Continually asses VS and distress (respiratory effort, nasal flaring, retraction, cyanosis) Polyhydramnios (too much amniotic fluid surrounding an unborn infant) Radiopaque catheter Chest x-ray Family assessment of anxiety, fears, concerns, and level of knowledge 3 C's when assessing and managing the child with EA and TEF Correct Answer: Coughing, choking with feedings, and cyanosis Prevent aspiration while neonate is being prepared for surgery TEF-Interventions Correct Answer: Immediately after birth: Radiant warmer Humidified O2 (Relieve R.distress) Preop: NPO IV fluids for hydration Maintaining thermoregulation (radiant warmer) and fluid balance Monitor Temp and VS Accurate I&O records Prevention of aspiration supine, 30*HOB(also reduces reflux) Suction catheter (into proximal pouch and mouth) (nose &mouth to keep area behind pouch empty) G-tube gravity feedings (to allow air to escape from the stomach) Constant R assessment Provide support to parents Postop: Monitor R.status Fluid, nutrition, temperature regulation Manage pain Monitor for infection Promote bonding Most likely will have a chest tube in place (ensure patency, monitor drainage, and document output) R.rate, effort, and presence of abnormal breath sounds Thermoregulation important because it can significantly affect R.status-warmer may still be needed IV ATBs Perenteral nutrition I&O Assess fluid and electrolyte imbalances (sunken fontanel and increased urine specific gravity) Daily weights and measurement of head circumference (assess growth) Double lumen cath to low suction GT to gravity drainage Tracheal suctioning Begin oral feedings A regurgitation of gastric contents back into the esophagus, is the result of relaxation of the lower esophageal sphincter Correct Answer: Gastroesophageal Reflux Disease Atresia= Correct Answer: closed Congenital malformation in which the esophagus terminates before it reaches the stomach and/or a fistula is present that forms an unnatural connection with the trachea. Correct Answer: TEF&EA Fistula= Correct Answer: opening EA with TEF same as EA but with? Correct Answer: distended stomach Celiac Disease-Teaching Correct Answer: Explain disease process Emphasize necessity of following gluten-free diet(hidden in labels as hydrolyzed vegetable protein)Important to read labels Dehydration Sub grains with corn, rice, millet Eliminate all wheat, rye, barley, oats and hydrolyzed vegetable protein from diet (pasta, baked products, breakfast cereals) Gluten-free substitutes Vitamin supplements (folate, fat-soluable vit. because hard to obtain in diet) When child is old enough, educate them on appropriate food choices Support groups available