Alterations in Gastrointestinal Functional: Esophageal Atresia & Tracheoesophageal Fistula Flashcards

1
Q

Esophageal Atresia & Tracheoesophageal Fistula: Epidemiology and Patho

A

1: 3500-4000 live births
Failure of esophagus to develop as a continuous tube during 4th & 5th week of gestation
Failure of trachea & esophagus to separate into 3 distinct structures

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2
Q

Manifestations (FDCCCS)

A

Frothy saliva in mouth & nose, drooling, cyanosis, choking, coughing, sneezing

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3
Q

Priority Concern

A

Risk of aspiration - cyanosis, apnea

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4
Q

EA & TEF Associated anomalies

A

congenital heart defects, GI or urinary tract anomalies, musculoskeletal abnormalities

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5
Q

50% associated with VATER or VACTERL Association: VATER

A

Vertebral defects
Imperforate Anus
TEF
Radial & Renal dysplasia

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6
Q

50% associated with VATER or VACTERL Association: VACTERL

A

Vertebral
Anal
Cardiac
Trachea
Esophageal
Renal
Limb

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7
Q

Most common type of EA and TEF

A

upper segment of the esophagus ends in a blind pouch connected to the trachea; the fistula connects the lower segment to the trachea
- breathe into stomach and into lungs and any food comes right back up

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8
Q

Pre-op Care

A
  • Surgical emergency; surgery ASAP with G-tube
  • HOB slightly raised to minimize aspiration
  • Maintain patent airway; NP suctioning prn
  • Continuos/low intermittent suction to blind pouch
  • NPO; IV fluids & antibiotics
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9
Q

Post-op care

A
  • IV fluids & antibiotics
  • pain management
  • TPN until oral or G-tube feeds tolerated -> go slow!! monitor weight gain or loss
  • Complications: GE reflux, aspiration, strictures
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10
Q

Discharge Planning

A

Parent teaching
- need to suction
- signs of respiratory distress (many will have some degree of tracheomalacia - softening of tracheal cartilage that causes a collapse)
- signs of constriction of esophagus (poor feeding, dysphagia, drooling, regurgitating undigested foods)
- precautions to initiate re: GER

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