Question

Baby boy Bardin is 28 hours old and has developed hyperbilirubinemia. His first-time parents have summoned you to their hospital room because they are very concerned about what this diagnosis means and how to treat it. (20 points each)

(1) Identify the expected assessment findings and physiologic effects related to hyperbilirubinemia. Include the schedule and how screening is performed during the postpartum period (blanching, transcutaneous, and serum methods).

(2) Discuss the risk factors associated with the development of hyperbilirubinemia.

(3) Explain the most common treatment for hyperbilirubinemia. Include the purpose of the treatment, expected timeframe for results, and evidence of the effectiveness of treatment.

(4) List the risks, precautions, and care measures required for the newborn undergoing phototherapy, including rationale for each action.

(5) Discuss treatment for severe hyperbilirubinemia or when phototherapy is not effective, and any follow-up testing that may be needed after treatment.

Answer 1

1- Large amounts of bilirubin that circulate to tissues in the brain can cause brain damage and seizures. This is a condition called kernicterus. Its screening is a routine checking for every newborn baby for high bilirubin levels in the blood. In screening, we require a small sample of blood from the baby's heel and then tested in a laboratory.

2- Common risk factors for hyperbilirubinemia are-

a- Blood group incompatibility,

b- prematurity,

c- trauma

3- The most common treatment for hyperbilirubinemia is phototherapy. It will stabilize the baby bilirubin level. Once the levels have stabilized, It'll be checked every 6 to 12 hours.

4- Risks of phototherapy include-

i- itchy skin

ii- nausea

iii- redness

Precautions-

i- TSB or SBR levels

ii- temperature

iii- adequacy of urine output

Care measures-

i- use shining fluorescent light

ii- The newborn should be placed under the lights without clothes.