Question

A newborn is transferred to the neonatal intensive care unit with an admitting diagnosis of esophageal atresia accompanied by a distal tracheoesophageal fistula (TEF). When assisting to care for the newborn, the priority concern would be:

a) Monitoring for signs of infection
b) Administering pain medication
c) Assessing respiratory status
d) Promoting parental bonding

Answer 1

The primary concern when caring for a newborn with esophageal atresia and a distal tracheoesophageal fistula is to assess respiratory status. This condition can cause aspiration and respiratory difficulties, necessitating close monitoring and potentially the use of life-saving interventions such as intubation and mechanical ventilation.

Step-by-step explanation:

When caring for a newborn with esophageal atresia and a distal tracheoesophageal fistula (TEF), the priority concern should be c) Assessing respiratory status. This condition poses a significant risk for aspiration and breathing difficulties, as the connection between the esophagus and the trachea allows gastric contents to enter the lungs. Therefore, meticulous monitoring of the infant's respiratory function is critical. Medical advances have resulted in enhanced treatment of respiratory distress syndrome (RDS), and the infant may require resuscitation and intubation if not breathing autonomously, and potentially the use of a ventilator or CPAP to assist breathing.

Treatment of newborns with TEF may also include the administration of pulmonary surfactant, a vital substance to reduce surface tension in the lungs and facilitate breathing, in cases of respiratory compromise. It's important to remember, though, that while the other options such as monitoring for signs of infection, administering pain medication, and promoting parental bonding are also essential components of care, they are secondary to ensuring the newborn's ability to breathe effectively.