Certified Pediatric Nurse (CPN)

For a newborn suspected of having TEF, which part of care would the nurse expect to provide?

1. A. Allow the mother to feed him slowly in a monitored area

2. B. Begin with IV fluids and IV antibiotics

3. C. Admit him to the ICU and place him on 100% O2

4. D. Allow parents to visit him but not hold him until just before surgery

The correct answer is: B. Begin with IV fluids and IV antibiotics

In the case of a newborn suspected of having tracheoesophageal fistula (TEF), it is crucial to manage the infant's care promptly due to the risk of aspiration and airway compromise that can occur with feeding. Beginning with intravenous (IV) fluids and IV antibiotics is appropriate because immediate oral feeding can lead to complications, including aspiration pneumonia, as the infant may not be able to effectively swallow. Using IV fluids ensures that the newborn receives necessary hydration and nutrition while minimizing the risk of aspiration. Additionally, the use of IV antibiotics is critical in preventing or treating any potential infections that might arise as a result of the aspiration or due to the underlying condition of TEF. This method of care is in line with the best practices for managing such conditions, emphasizing the importance of stabilizing the newborn before any surgical intervention and addressing potential infections. This approach limits the risk of complications and allows the healthcare team to monitor the baby's condition closely until further diagnostic measures and treatment can be undertaken.