Nursing 209

N209: Reproductive Health Study Guide • • There are five types; four out of the five also involve TEF • Signs and symptoms: Cyanosis, choking and gagging with feeding attempts, and drooling • Diagnosed prenatally on an ultrasound; in a newborn, with unsuccessful NGT placement attempt (unable to pass) and x-ray • Treatment: Surgical repair (first repair performed in 1939; prior to that condition was fatal) • Preoperatively: Oral feeds are held o Continuous NGT suction in upper esophageal pouch to prevent aspiration o Prone position with HOB elevated 30-40 degrees; right side is down to enhance gastric emptying Tracheoesophageal Fistula (TEF) • Abnormal connection (fistula) between esophagus and trachea • Most common anatomic TEF consists of a blind esophageal pouch with a distal TEF • Occurs in 1:2000-4000 live births • Survival rate is 100% if the infant does not have any other severe congenital anomalies 6.3 Digestive Defects • About one-third of infants with a GI defect also have another congenital anomaly • Evaluation should also be done to check for malformation of other organs • Most congenital anomalies cause intestinal obstruction, so the baby will present with feeding problems, abdominal distention, and vomiting within the first few days of life • Outcome depends upon the malformation, with some anomalies having a mortality rate of up to 30% Biliary Atresia • Incomplete bile ducts with blockage of bile from the liver to gallbladder • Bile is then trapped within the liver, causing scarring (cirrhosis) • Can eventually lead to liver failure • Occurrence is rare, 1:15-20,000 births • Affects girls more than boys • More common in Asian and African American populations • Common for only one child in the family to have the disorder • Can occur during pregnancy for some babies, while others may have damage as a result of an immune response to a virus after birth Occurs in 1:3500 live births

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