Question 1

What is jaundice aka neonatal hyperbilirubinemia

Accepted Answer

accumulation of bilirubin in the skin Approximately 60% of term newborns are jaundiced in the first week of life

Question 2

What clinical observation indicates jaundice

Accepted Answer

orange/yellow or green hue to skin typically apparent when serum bilirubin lev- els exceed 5 to 7 mg/dL

Question 3

When does jaundice occur and resolve

Accepted Answer

occurs around 3rd day of life; resolves around have 10-12 asian babies develop it a bit later and resolves a bit later

Question 4

How can jaundice be impacted by breast feeding

Accepted Answer

can get early and late onset jaundice - typically as result of infrequent and insufficient intake leading to decreased intestinal motility

Question 5

What are the 5 common reasons for jaundice

Accepted Answer

increased hemolysis (isoimmunization-mothers immune system attacks babys RBCs causing lysis) Polycythemia (increased RBC mass) Delayed cord clamping (baby gets increased blood from placenta) Liver immaturity or defects Abnormal excretion or absorption like delayed stooling The following are risk factors for the devel- opment of pathologic hyperbilirubinemia: Hemolytic disease, anemia Inborn errors of metabolism Prematurity (gestational age 35 to 36 weeks) Significant bruising or cephalohematoma Exclusive breastfeeding with significant weight loss or difficulty in feeding Jaundice that develops in the first 24 hours of life The total bilirubin increases more than 5 mg/dL/24 hours, is more than 12.5 mg/dL before 48 hours old, or the direct bili- rubin exceeds 2 mg/dL Ethnic or geographic origin associated with hemolytic anemia (African or Mediterranean descent) Hepatobiliary disease Previous sibling required phototherapy

Question 6

FYI signs of jaundice

Accepted Answer

Petechiae, bruising, hepatosplenomegaly, or signs of infection Lethargy, hypotonia, poor feeding, and loss of the Moro reflex are common initial signs of bilirubin toxicity to the brain (ker- nicterus). These symptoms are subtle and indistinguishable from those of sepsis, asphyxia, hypoglycemia, intracranial hem- orrhage, and other acute illnesses in the neonate. Later signs of kernicterus include diminished tendon reflexes, respiratory distress, failure to suck, opisthotonos, bulging fon- tanelle, twitching of face or limbs, seizures, and a shrill, high- pitched cry.

Question 7

What are common treatments of jaundice

Accepted Answer

Phototherapy regular breastfeeding 8-12x per day

Question 8

What is the best preventor of SIDS sudden infant death syndrome

Accepted Answer

placing newborn supine instead of face down to sleep most SIDS liked to suffocation

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2.3 Developmental Assessment - common neonatal skin conditions and HEENT conditions - Jaundice Flashcards

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