Certified Pediatric Nurse (CPN)

When reviewing the history of a newborn diagnosed with TEF, which finding would the nurse most likely expect?

1. A. Tolerated feedings for a few days before projectile vomiting

2. B. Mother stated she barely looked pregnant

3. C. Continuously appeared hungry despite being fed every 2 hours

4. D. Had a lot of secretions and became cyanotic when fed

The correct answer is: D. Had a lot of secretions and became cyanotic when fed

In cases of Tracheoesophageal Fistula (TEF), it is common for newborns to exhibit significant respiratory distress and secretions during feeding. This occurs due to the abnormal connection between the trachea and esophagus, which allows food or liquid to enter the airway. As a result, when the infant is fed, the chances of aspiration increase, leading to a buildup of secretions in the airways. The observation of becoming cyanotic is particularly crucial, as it indicates a lack of adequate oxygenation which is often a consequence of aspiration or compromised airway integrity associated with TEF. This symptom highlights the serious nature of the condition, underscoring the need for immediate medical intervention to avoid complications like respiratory distress. The other findings, while they may arise in different contexts or conditions, do not directly reflect the classic presentation of TEF. For instance, symptoms like projectile vomiting or continuously appearing hungry can occur in various gastrointestinal disorders, but they are not as definitive as the symptoms associated with TEF. Generally, the hallmark signs of TEF involve severe respiratory issues and feeding difficulties, making the presence of secretions and cyanosis during feeding a key indicator of this diagnosis.