Impaired Swallowing and Altered Family Processes r/t Newborns with Esophageal Atresia

Nursing Diagnosis and Interventions for Newborns with Esophageal Atresia

Nursing Diagnosis : Impaired Swallowing related to mechanical obstruction.

Goal: Patient getting adequate nutrition.

Outcomes: The baby gets enough nutrients and showed satisfactory weight gain.

Intervention:

• Give fed through gastrostomy in accordance with the provisions.
• Continue oral feeding as applicable, under the conditions of infants and surgical repair.
• With strict observation.
• Monitor input and output weight.
• Teach families about proper feeding techniques.

Rational:

• To meet the nutritional needs of infants
• To assess the adequacy of nutrient inputs.
• To make sure the baby is able to swallow without choking.
• To provide nutrients to allow oral feeding.
• To prepare for the return.

Nursing Diagnosis : Altered Family Processes related to babies with physical defects.

Goal: patient (family) prepared for child care at home.

Outcomes : Families demonstrate the ability to provide care to infants, understanding the signs of complications, and appropriate action.

Intervention:
Teach the family about the skills and needs of nursing home observations:

• Give position.
• Signs of respiratory distress.
• Signs of complications; refusing to eat, dysphagia, increased cough.
• The need for tools and materials needed.
• Gastrostomy care if the infant had surgery, including techniques such as suction, feeding, or ostomy care operasidan side, and a replacement bandage.

Rational

• To prevent aspiration.
• To prevent delays in action.
• So that practitioners can be notified.
• To ensure proper care after discharge.

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Nursing Care Plan for Esophageal Atresia

Esophageal atresia occurs in about one in 3000-4500 live births, one third of affected children are usually born prematurely. In over 85% of cases, a fistula between the trachea and distal esophageal, accompanying atresia. Very rarely, esophageal atresia or tracheal esophageal fistula occur alone or with a strange combination. Esophageal atresia is a congenital abnormality include group consisting of disruption of continuity of the esophagus with or without connection to the trachea. Infants with Esophageal Atresia is unable to swallow saliva and marked with a bunch of very large amount of saliva and requires suction repeatedly.

The possibility of atresia increased with the discovery of polyhydramnios. Nasogastric tube can still be passed at the time of birth of all babies are born with maternal polyhydramnios as well as infants with excessive mucus, soon after the birth to prove or disprove the diagnosis. In esophageal atresia hose will not pass more than 10 cm from the mouth (confirmation with Rongent chest and abdomen).

Until now not known what teratogenic substances that can cause abnormalities Esophageal Atresia, just reported recurrence rate of about 2% if one of the affected siblings. But now, the theory about the occurrence of esophageal atresia according to most experts no longer associated with a genetic disorder. The debate on embryo-pathological process continues, and only a little is known.

The triggers that cause congenital birth as esophageal atresia are as follows:

• In the case of polyhydramnios.
• Preterm infants.
• If the catheter is used for resuscitation at birth can not enter into the stomach.

There are some circumstances that the symptoms and signs of esophageal atresia, among others:

• Mouth foaming (bubbles of air from the nose and mouth) and saliva from the mouth of a baby is always melted.
• Cyanosis.
• Cough and shortness of breath.
• Symptoms of pneumonia caused by regurgitation of saliva from the esophagus were clogged and regurgitation of gastric fluid through the fistula into the airway.
• Abdominal bloating or bulge, because the air through the fistula into the stomach and intestines.
• Oliguria, because there is no fluid intake.
• Usually accompanied by other congenital abnormalities, such as heart defects, atresia of the rectum or anus.
• The presence of aspiration when the baby is drinking.
• Projectile vomiting.

Nursing Diagnosis for Esophageal Atresia

1. Impaired swallowing related to mechanical obstruction.
2. Risk for injury related to surgical procedures.
3. Anxiety related to difficulty swallowing, discomfort due to surgery.
4. Altered family processes related to children with physical defects.

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