Jaundice Flashcards
Case: A 3 dav old neonate was brought to the pediatric unit with complaints of vellow skin and sclera. Counsel the mother on her child’s condition
GATHER
Greet- GRIP : (Greet. create Rapport. Introduce vourself obtain Permission\
Good morning ma, How are you today? My name is *****. | am a candidate for the ongoing MDON exams. For the purpose of my exams, I have been asked to counsel you about your child’s condition. May I proceed?
Quick biodata: -Name, age and sex of child?
-Name, relationship and highest level of
education of the informant
Setting: LCCC
Lanquage: Are vou comfortable communicating in English?
Comfort: Are vou comtortable here or would would like to go somewhere more private?
Companion: is there a friend or loved one you like present?
Confidentiality: .ok . I would like to assure you that our conversation is strictly confidential
Ask
- What do you know about Neonatal jaundice?
-Detine: Jaundice is a vellow discoloration of skin and mucous membrane due to increased serum bilirubin which comes from breakdown of red blood cells
Neonatal jaundice is the jaundice seen in early period of life
From birth to 1-2 months of life
Normal serum bilirubin is less than 3mg/kg
-Jaundice in neonates is obvious when serum bilirubin is greater than 5mg/ kg
- Epidemiology.
Neonatal jaundice is a common condition affecting 60% of term and 80% of preterm newborns globally. It occurs more trequently in male than female
Aetiology/Risk factors (RF):
-
Possible causes include: Sepsis. Bruising from difficult birth.
Rh incompatibIlity.
ABO Incompatibility.
LacK of breast feeding etc.
-Classification:
Increased breakdown of Red blood cells- Hemolytic jaundice
Normal breakdown of RBCs but inadequate excretion due to obstruction : Obstructive Jaundice
Physiologic iaundice - is caused by abnormal metabolism of bilirubin . which appears after 2-3days of birth .
Clears up on its own after a few weeks when the breakdown of RBs slows and
liver Function improves
Pathological jaundice - Is present on the tirst day of Ife, appears within 24hrs of birth, and the babys serum level of bilirubin continues to rise over time.
Clinical Features signs a symptoms):
Complications
-Clinical Features signs a symptoms):
yellow discoloration of skin , mucous memoranes and whites of the eves.
Light coloured stool
Poor feeding
Lethargic (excessive sleepiness)
Changes in muscle tone (either listless or stiff with arching of the back)
-High pitched crying
-Complications:
Seizures
Cerebral palsv (brain affection]
Deafness
Intellectual impairment
However, I’m glad you are here, our team of Doctors and
nurses with give adequate care
to your baby to prevent these
complications.
Diagnostic and treatment
To properly care for your baby, we will do some tests which include Blood test to check for infection, level of bilirubin, type of bilirubin present and blood ( fbc, serum bilirubin, combs test)
-Treatment:
Mild jaundice usually resolves on it’s own
We wIl treat anv underlving cause
Phototherapy- this is where we undress your baby and place
under a blue light to held remove the bilirubin through the skin
Exchange blood transfusion- Done in case of severe jaundice.
We will remove some of vour babv’s blood and replace equal amount from a donated blood
Help empathy and retell
HELP
- will encourage to feed your child adequately, at least every 2 hrs
-Do not put camphor in vour house
. Empathy:
From beginning to end of counselling
I wIll like to assure you that our team is highly competent in managing NNJ and preventing the complications we discussed. vve wIll ensure your baby gets the best possible care
- RETELL:
-Do you understand all I have said?
-Do you have any questions for me?
-Kindly repeat what you understand in your own words
-Alter discharge. vou will bring baby in one week for a follow up visit
-Thank you ma!
