Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Jaundice - Newborn
Physiologic Jaundice of the Newborn
| Question | Answer |
|---|---|
| What is the most immature of the GI organs in a newborn? | The newborn liver. |
| Characteristics of the newborn liver. | Most immature of the GI organs,activity of the enzymes leads to jaundice. Deficient protein leads to edema. There is a low prothrombin and other factors. The liver stores less glycogen leading to hypoglycemia. |
| What can cause hyperbilirubinemia? | Excess production of bilirubin. A disturbed capacity of the live to conjugate bilirubin. Bile duct obstruction secondary to Biliary atresia. |
| What is biliary atresia? | congenital absence or obstruction of the bile ducts. |
| What is the most common cause for a pediatric liver transplant? | bilary atresia |
| What are the two things that can be done for biliary atresia? | Surgery (Kasia Procedure) and liver transplant. |
| What is Kasai Procedure | They take a piece of jejunum and make a new bile duct. It is best if it is performed before 2 months of life. |
| Why is it best to do the Kasai procedure before 2 months of life? | Because the you wont end up with as much liver damage from the back up. |
| What do babies with biliary atresia eat? | A specially engineered formula that has fats that don't need to bile to be broken down. There are also vitamins that are water miscible. (A,D, E, & K) |
| A baby who has biliary atresia is going to have jaundice and is going to experience itching. What medication will be given to this infant? | Questran |
| Why would phenobarbitol be given to an infant with biliary atresia? | To calm them down. |
| Infants with biliary atresia may have deficient protein pruduction so they are more likely to have: | Edema |
| Because of the edema biliary atresia is likely to cause what kind of a diet would the patient be on? | Low sodium and also diuretics to get rid of the excess fluids. |
| As toxins build up the baby's system because of biliary atresia, it becomes more difficult to calm. What do we do? | We use a sedative and comfort measures. |
| What is a T-tube used for? | To determine whether the new liver, or bile duct is patent. |
| Physiologic jaundice is actually: | normal jaundice |
| What causes physiologic jaundice? | Immature bilirubin metabolism and transport and increased bilirubin from hemolysis. |
| What is normla INFANT bilirubin? | 0.2 - 1.4 |
| At what point is jaundice shown in infants? | Only 1/2 of babies show jaundice because eventually their bodies catch up. It is only seen if the Total bilirubin is >5. |
| Normal newborn production of bilirubin is: | 2x normal bilirubin production |
| If you see jaundice before 24 hours in a full term infant, what could the cause be? | Sepsis |
| If you see jaundice in a preterm infrant before 48 hours, what does this incdicate? | There is something wron. It is nopt physiologic. |
| When refering to jaundice, post mature babies should have: | little or no jaundice |
| If jaundice occurs when an infant is breastfeeding what action should be taken? | Stop breast feeding for 2-4 days and see if the bilirubin levels drop. |
| While jaundice in the first 24 hours is not normal, what could be the contributing factors to its occuring? | Hemolytic(excessive breakdown of RBC's), sepsis, or maternally derived. |
| If jaundice occurs in the first 24 hours, and it is maternally derived, what could some possible causes be? | Rh negative mom and a Rh positive baby. Erythroblastosis Fetalis, Hydrops Fetalis. |
| What is Erythroblastosis Fetalis? | Excessive RBC destruction of the fetus. You end up with decreased oxygen to the tissues (hypoxia). |
| What are some of the symptoms of Erythroblastosis Fetalis? | Hypoxia, tachycardia from the heart pumping harder to get oxygen to the tissues. Increased HR and eventually stress on the myocardium which will lead to decreased cardiac output. This can then lead to CHF. |
| What is Hydrops Fetalis. | This condition is extreme, whole body inflammation. The babies end up going into CHF. Most of these babies are stillborn. |
| What kind of diagnostic tests will be done to determine maternally derived pathologic problems. | Direct Coombs test, amniocentesis, intrauterin tranfusions. |
| What medication is given to prevent the whole tradgedy of erythroblastosis fetalis and hyrops fetalis? | Rhogam is given after the deliver of the first baby and during the pregnancy of subsequent pregnancies. |
| Normal jaundice peaks on the 2-4th day and is decreased between: | 5-7 days. |
| Normal jaundice peaking 2-4 days is usually considered: | physiologic jaundice |
| Infants with sever jaundice can develop: | Kernicterus (severe brain damage, unconjugated bilirubin highly toxic to neurons) |
| Kernicterus can cause: | brain damage in infants |
| Any newborn with a 20+ bilirubin may need: | an exchange transfusion if illness or associaed conditions are present |
| If the bilirubin is 20-24 and the cause is NOT pahtological, there is no risk of: | brain damage |
| What are the only two times that you are going to see brown amniotic fluid? | Either meconium an there or jaundice both are abnormal. |
| What do we do before an exchange transfusion? | Type and cross match the baby. Confirm at blood bank and at bedside with another nurse. |
| What do we do before an exchange transfusion? | Wmaintain asepsis and monitor vital signs Q15 minutes. Have a crash cart at the bedside in case of anaphylaxis. |
| What do we do after an exchange transfusion? | Monitor vital signs Q15 minutes for the first hour and monitor for of transfusion reaction. |
| What are som of the signs of transfusion reaction? | Increased temperature, rash, chills, fever, fussiness and irritability in a baby. |
Created by:
jjcthirdsemesterflashcards
Popular Nursing sets