caring for newborns
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is hyperbilirubinemia common in newborns.
yes. in the newborn, an imbalance between bilirubin production and bilirubin metabolism or clearance from the body results in an excess of circulating bilirubin and thus jaundice is common. bilirubin is one of the breakdown products of hemoglobin that results from red blood cell destruction.when rbc's are destroyed,the breakdown products are releaded into the circulation, where the hemoglobin splits into two fractions:heme and globin. the globin portionis used by the body,and the heme portion is converted to unconjugated bilirubin,an insoluble substance bound to albumin.
what are the signs and symptoms?
- jaundice/yellow tint of skin.
- sclerae may also be yellow.
- dark yellow urine
what are the diagnostic evaluations?
- serum bilirubin/ total and direct
- transcutaneous bilirubin monitoring
- direct coombs test
- if hemolysis is present or suspected,other tests may be appropiate: cbc,g6pd,rbc morphology, albumin, reticulocyte count, pt, and ptt.
- end-tidal carbon monoxide/ levels measured in exhaled breath may be of value in determining the presence of hemolysis and the rate of heme degradation and bilirubin production in some infants.
what is the nursing care?
- early detection of jaundice.
- initiate early feedings in healthy newborn.
- diagnostic tests/bilirubin and transcutaneous bilirubin monitoring
- pt. education, support, and reassurance.
- treatment/ phototherapy_ light therapy, eye protection, observation for complications such as dehydration, temperature,irritability; maternal and paternal contact during treatment/skin care.
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