Jaundice hx + mx

Question 1

focussed hx

Answer 1

when did it start
where did it start & spread to
pale stools/dark urine?

Question 2

red flags

Answer 2

poor feeding
floppy (hypotonia)
seizures
fever

Question 3

brief counselling on jaundice

Answer 3

v v common

yellowing due to ++ bilirubing

breakdown of RBC (foetal Hb) + immature liver –> increased bilirubing production & not enough clearance

breast feeding RF but benefits&raquo_space; risks

Question 4

Ix

Answer 4

transcutaneous bilirubinometer

if <24hrs - serum bilirubin

Question 5

mx

Answer 5

plot on bilirubin chart CORRECT FOR GESTATION

phototherapy - lies under lamp with eyes covered for 4 hours // 30 mins break feed hug etc // bilirubin levels checked every 4 hrs till safe levels

exchange transfusion

IVIG in Rh disease