QLexNursing

A. Keep the child NPO (Nothing by Mouth)

🛑 The most immediate nursing action in any suspected case of foreign body ingestion, particularly involving a button battery, is to maintain NPO status.

🛑 NPO is essential to reduce the risk of aspiration during sedation or procedural intervention, especially if endoscopic removal becomes necessary.

🛑 Button batteries can cause tissue necrosis, perforation, or hemorrhage within as little as 2 hours, making this a surgical emergency.

🛑 The presence of drooling, gagging, and wheezing indicates airway irritation and possibly esophageal impaction, further reinforcing the need to withhold oral intake immediately.

🛑 B. Prepare the child for flexible endoscopy

🛑 Once the child is stable and NPO, the next priority is to prepare for urgent endoscopic removal of the foreign object.

🛑 The X-ray confirms the presence of an object in the esophagus, which requires direct visualization and retrieval using a flexible endoscope under sedation.

🛑 Endoscopy is both diagnostic and therapeutic, allowing removal of the foreign body and assessment of tissue damage.

🛑 Delaying intervention could result in mucosal ulceration, perforation, or even fistula formation, especially with batteries, which leak alkaline substances.

🛑 The child’s vital signs (mild hypotension, increased respiratory rate) and respiratory symptoms (expiratory wheezing) suggest ongoing physiologic stress, making timely endoscopy imperative.