A nurse is caring for an infant with a tracheoesophageal fistula who is scheduled for surgery.
What actions should the nurse anticipate taking in the pre-operative and intra-operative period? (Select all that apply)

Choice A rationale

Pain management is crucial after a tonsillectomy. Pain can prevent children from eating or drinking, leading to dehydration. Therefore, ensuring that the child’s pain is well managed is an important part of post-operative care.

Choice B rationale

Mild ear pain or bad breath after surgery can be signs of complications such as infection. Therefore, parents should be instructed to report these symptoms if they occur.

Choice C rationale

After a tonsillectomy, the throat is often sore and swollen. Eating soft foods can help prevent further irritation or injury to the throat. Crunchy foods could scratch the healing throat and cause discomfort.

Choice D rationale

While it’s true that scabs will form on the tonsils as they heal, it’s important to monitor them. If a scab dislodges too early, it can cause bleeding. Therefore, this statement is not entirely accurate and should not be included in the discharge instructions.

Choice A rationale

Administering enteral bolus feeds prior to surgery is not typically recommended for infants with a tracheoesophageal fistula. This is because the fistula can allow food or liquid to enter the trachea and lungs, leading to aspiration and potential respiratory complications.

Choice B rationale

Administering Famotidine prior to surgery can help reduce the risk of gastric acid reflux, which can lead to aspiration during surgery. This is particularly important in infants with a tracheoesophageal fistula, as the fistula can allow stomach contents to enter the trachea.

Choice C rationale

Administering IV antibiotics prior to surgery can help prevent infection. This is a common practice in many types of surgery, including surgery to repair a tracheoesophageal fistula.

Choice D rationale

Administering IV fluids during surgery can help maintain hydration and electrolyte balance. This is particularly important in infants, who have a higher risk of dehydration.

Choice E rationale

Administering 100% oxygen via a non-rebreather mask during surgery can help ensure that the infant has adequate oxygen levels. This is particularly important during surgery, as the infant will be under general anesthesia.