NURS 372 PEDIATRICS FINAL REVIEW WITH
QUESTIONS AND 100% CORRECT ANSWERS!!
Define Lactation
answers: The secretion of milk by the breasts
What can cause hyperbilirubenia (4)
answers: 1. Liver isn't functioning well
2. Hemolytic disease of the newborn
3. Inadequate feeding, hydration, and excretion
4. Cephalohematoma
How is bilirubin excreted?
answers: Must be conjugated so it becomes soluble and excretable
What are 4 physiological reasons for jaundice
answers: 1. High RBC mass and short RBC lifespan
2. Reduced ability of liver to conjugate
3. Fewer bilirubin binding sites
4. Conjugated changes to un-conjugated in intestines (antibiotics)
What does indirect bilirubin mean
answers: Un-conjugated
What happens to indirect bilirubin that doesn't bind to albumin (2)
answers: - Leave vascular system and enters other extravascular tissues such as
skin, sclera, and oral mucous membranes
,- can cross BBB and cause neurotoxicity
What is jaundice
answers: Yellowing of the skin, sclera, and mucous membranes
When are peak bilirubin levels reached?
answers: between day 3 and 5 in full term newborns
How can mom and dad help with jaundice in their baby?
answers: - Monitor diapers (1-2 stools and at least 6 wet diapers)
- assess jaundice in the natural light
- increase feeding
What is the degree of jaundice determined by
answers: Unconjugated + conjugated + total serum bili
What does hyperbilirubinemia mean?
answers: elevated serum bilirubin levels and is toxic to the brain
What value of un-conjugated bilirubin in the first __ days of life constitutes
hyperbilirubinemia
answers: 340 and 28 days
What are complications of hyperbilirubinemia? (6)
answers: Kernicterus
encephalopathy
,motor abilities
hearing and vision loss
severe learning delays
lifelong neurological challeneges
Contributing factors of hyperbilirubinemia
answers: - Liver immaturity
- fatty acids from cold stress or asphyxia
- delayed feeding
- trauma resulting in bruiswing or cephalohematoma
- lack of intestinal flora
What are the 7 questions for evaluating hyperbilirubinemia?
answers: 1 was the baby premature?
2 did the baby experience birth trauma
3 is the baby indigenous or asian
4 did any of the baby's siblings have jaundice
5 ABO incompatibility with mom
6 Fewer than 6 wet diapers/day
7 is the baby a boy
How do we check for jaundice without the machine?
answers: Blanch the skin over a bony prominence (sternum), after the pressure is
released does the area appear yellow before normal colour appears
can also check oral mucous membranes
How do you do transcutaneous bilirubin screening?
, answers: should be measured in the first 72 hours of life or earlier in the presence
of clinical jaundice
measured 3 times on sternum
What is the first test done for jaundice
answers: TCB is done first unless there is reason to believe the pathological
jaundice
What is phototherapy?
answers: Exposure to high intensity light to reduce serum bilirubin levels
What are the 6 safety precautions before baby is in phototherapy
answers: obtain vital signs before
remove all infants clothing except diaper
apply eye coverings
ensure lights are at appropriate distance
Reposition every 2 hours
dont use vaseline (burn the skin)
What do you assess (3) in phototherapy
answers: skin for breakdown
intake and output
serum bilirubin
When can baby leave the light for phototherapy
QUESTIONS AND 100% CORRECT ANSWERS!!
Define Lactation
answers: The secretion of milk by the breasts
What can cause hyperbilirubenia (4)
answers: 1. Liver isn't functioning well
2. Hemolytic disease of the newborn
3. Inadequate feeding, hydration, and excretion
4. Cephalohematoma
How is bilirubin excreted?
answers: Must be conjugated so it becomes soluble and excretable
What are 4 physiological reasons for jaundice
answers: 1. High RBC mass and short RBC lifespan
2. Reduced ability of liver to conjugate
3. Fewer bilirubin binding sites
4. Conjugated changes to un-conjugated in intestines (antibiotics)
What does indirect bilirubin mean
answers: Un-conjugated
What happens to indirect bilirubin that doesn't bind to albumin (2)
answers: - Leave vascular system and enters other extravascular tissues such as
skin, sclera, and oral mucous membranes
,- can cross BBB and cause neurotoxicity
What is jaundice
answers: Yellowing of the skin, sclera, and mucous membranes
When are peak bilirubin levels reached?
answers: between day 3 and 5 in full term newborns
How can mom and dad help with jaundice in their baby?
answers: - Monitor diapers (1-2 stools and at least 6 wet diapers)
- assess jaundice in the natural light
- increase feeding
What is the degree of jaundice determined by
answers: Unconjugated + conjugated + total serum bili
What does hyperbilirubinemia mean?
answers: elevated serum bilirubin levels and is toxic to the brain
What value of un-conjugated bilirubin in the first __ days of life constitutes
hyperbilirubinemia
answers: 340 and 28 days
What are complications of hyperbilirubinemia? (6)
answers: Kernicterus
encephalopathy
,motor abilities
hearing and vision loss
severe learning delays
lifelong neurological challeneges
Contributing factors of hyperbilirubinemia
answers: - Liver immaturity
- fatty acids from cold stress or asphyxia
- delayed feeding
- trauma resulting in bruiswing or cephalohematoma
- lack of intestinal flora
What are the 7 questions for evaluating hyperbilirubinemia?
answers: 1 was the baby premature?
2 did the baby experience birth trauma
3 is the baby indigenous or asian
4 did any of the baby's siblings have jaundice
5 ABO incompatibility with mom
6 Fewer than 6 wet diapers/day
7 is the baby a boy
How do we check for jaundice without the machine?
answers: Blanch the skin over a bony prominence (sternum), after the pressure is
released does the area appear yellow before normal colour appears
can also check oral mucous membranes
How do you do transcutaneous bilirubin screening?
, answers: should be measured in the first 72 hours of life or earlier in the presence
of clinical jaundice
measured 3 times on sternum
What is the first test done for jaundice
answers: TCB is done first unless there is reason to believe the pathological
jaundice
What is phototherapy?
answers: Exposure to high intensity light to reduce serum bilirubin levels
What are the 6 safety precautions before baby is in phototherapy
answers: obtain vital signs before
remove all infants clothing except diaper
apply eye coverings
ensure lights are at appropriate distance
Reposition every 2 hours
dont use vaseline (burn the skin)
What do you assess (3) in phototherapy
answers: skin for breakdown
intake and output
serum bilirubin
When can baby leave the light for phototherapy
