What should a nurse do to assess for tracheo-esophageal fistula with esophageal atresia if an infant chokes, coughs, or becomes cyanotic during the first feeding?

Assessing for tracheo-esophageal fistula with esophageal atresia in an infant who presents with choking, coughing, or cyanosis during the first feeding is crucial. The correct approach involves gently passing a catheter into the esophagus. This method allows the nurse to determine whether the esophagus is continuous or if there is a blockage due to atresia. If a catheter cannot be passed, it indicates a possible obstruction or atresia, highlighting the need for further evaluation.

Utilizing this technique is essential because it provides immediate information about the esophageal condition without causing harm. Gently passing a catheter is a non-invasive assessment that can guide further management and intervention.

Other methods, such as a barium swallow test, while useful in diagnosing esophageal issues, are not appropriate in the acute setting of choking or respiratory distress. Immediate surgery might ultimately be necessary in cases where there is a confirmed tracheo-esophageal fistula, but such a decision follows initial assessment and diagnostics. Placing the infant in a lateral position could be a supportive measure to help with airway management but does not specifically assess for the presence of a fistula or atresia.

Thus, gently passing a catheter into the esophagus serves as an effective assessment tool