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68wm6 p2 Var Nor New

Variations in the Normal Term Newborn

What are the two types of jaundice? *Physical jaundice *Pathological jaundice
When does physical jaundice occur? Is not present during the first 24 hours of life in term infants but appears on the second or third day after birth
True or False: Jaundice in the 2nd or 3rd day of the newborns life is indicative of an underdeveloped liver and is a critical condition False. It is physical jaundice and is considered a normal phenomenon
At what biliruben level does jaundice occur? 5-7mg/dL
At what biliruben level does jaundice occur in the face? 5-7mg/dL
At what biliruben level does jaundice occur in the midabdomen? 15mg/dL
At what biliruben level does jaundice occur on the soles of the feet? 20mg/dL
When does pathological jaundice occur? during the first 24 hours after birth
What are the nonphysiological causes of pathological jaundice? *A direct bilirubin level above 1.5 to 2 mg/dl *Total serum bilirubin concentration increasing by more than 0.2 mg/dl per hour or 5 mg/dl per day *Clinical jaundice that lasts more than 2 weeks in a full term infant
What are the most common causes of pathological jaundice? *Abnormalities causing excessive destruction of erythrocytes *Incompatibilities between mother’s and infant’s blood types *Infection *Metabolic disorders
What can severe jaundice lead to? Kernicterus
What is kernicterus? damage to the brain centers of infants caused by increased levels of unconjugated bilirubin
Infants who survive kernicterus may suffer from what? *Cerebral palsy *Mental retardation *Hearing loss *More subtle long-term neurologic and developmental problems
List four factors that increase hyperbilirubinemia in newborns: *Hemolysis of excessive erythrocytes *Short red blood cell life *Rh incompatibility with mother *Infection *Liver immaturity *Lack of intestinal flora *Delayed feeding *Bruising or cephalohematoma *Fatty acids from cold stress or asphyxia
What is the most common Tx of bilirubenemia in newborns? Phototherapy is most common treatment and involves placing the infant under special fluorescent lights
What intervention is done when phototherapy cannot reduce a newborns bili levels quick enough? Exchange transfusion
What is an exchange transfusion? Donor blood is givin through the umbilical vein and newborns waste blood is drained from the umbilical artery.
What is erythema toxicum? A benign rash of unknown cause in newborns, blotchy red areas that may have white or yellow papules or vesicles in the center
When does erythem toxicum occur? Rash appears during the first 24 to 48 hours after birth, although occasionally as late as 1 to 2 weeks
Where is erythema toxicum most commonly located on the newborn? face, back, shoulders, and chest
What is the differential Dx of erythem toxicum? pustular rash cause by staph infection or vesicles from herpes simplex
How long does erythema toxicum last? Hours to 10 days
What are mongolian spots? Bluish black marks that resemble bruises
Where do brown spots usually occur? Sacral area
Who are mongolian spots most common in? Newborns with dark skin
What are Petechiae? Pinpoint bruises that resemble a rash
What causes petechiae? Increased intravascular pressure
What can petechiae indicate? infection or a low platelet count
What is Nevus Simplex? Flat, pink, or reddish discoloration that is usually on face or neck and disappears by 2 years of age
What is Nevus Flammeus (Port Wine Stain)? Permanent, flat, dark, reddish-purple mark that varies in size and location. Can be removed by laser surgery
What is Nevus Vasculosus (Strawberry Hemangioma)? Enlarged capillaries in the outer layer of skin that makes the skin appear dark red and raised with a rough surface
What is the Tx of nevus vasculosus? No Tx necessary
What is Cutis Marmorata? A lace-like red or blue pattern on the skin that is caused by cold stress, overstimulation, hypovolemia, or sepsis
What may cutis marmorata indicate? Chromosomal abnormality
What is Harlequin Color Change? Deep red color over half of body with pallor on the other half of the body
What causes harlequin color change? Cause is unknown, though it usually occurs with preterm infants who are placed on their side
What is acrocyanosis? Peripheral cyanosis that appears on hands and feet.
When is acrocyanosis common? during the first day and is a result of poor peripheral circulation
What is the most common surgical procedure of the neonate? Circumcision
Created by: Shanejqb