Neonatal Jandus

Question 1

Describe assessing clinical jaundice in which corresponds to body?

Answer 1

Jaundice of face with Bilirubin approximately five, mid abdomen approximately 15, feet approximately 20

Question 2

Went should phototherapy be used?

Answer 2

Consider phototherapy at levels greater than 12 for infants 25 to 48 hours old. Definitely do phototherapy if levels are greater than 15 mg/dL

Question 3

When should the phototherapy be escalated?

Answer 3

Levels greater than 25 then exchange transfusion and intensive phototherapy

Question 4

How often should H&H measurements be assessed?

Answer 4

Q8H

Question 5

What test should be ran in order to monitor signs of infection?

Answer 5

First and second CRP levels

Question 6

What titers should be sent for Jaundice ? Why I made this not be necessary?

Answer 6

CMV, rubella, toxoplasmosis; Titers will not be available the first 48 hours of evaluation

Question 7

What are the signs of sepsis? When do you think it should be suspected in this patient? What should be done?

Answer 7

Difficulty feeding, fever, lethargy; Change in patient’s clinical status, empiric antibiotics therapy along with urine and spinal cultures

Question 8

Why is frequent breast-feeding it’s important for this patient?

Answer 8

In order to keep the baby well hydrated and for the mother to assess signs of infection, poor feeding

Question 9

How is cephalohematoma a risk factor for elevated jaundice?

Answer 9

Increase source of Billy Rubin production as hemorrhage reabsorbs

Question 10

What is the rate in which physiologic Jaundice will increase in Bilirubin levels? When does it peak? Do these kids usually present with Jaundice within the first 24 hours?

Answer 10

Less than 5mg/dL per 24 hours; On day three with level no greater than 13, no

Question 11

When does breast-feeding Jaundice occur?

Answer 11

Doesn’t reach clinical levels within the first 24 hours however does present within the first five days

Question 12

When does breast milk Jaundice occur?

Answer 12

Occurs towards the end of the first week in an infant that is otherwise thriving

Question 13

What are the other pathological mechanisms besides breast milk that can cause Jaundice?

Answer 13

Liver disorders such as biliary atresia. Metabolic disorders such as galactosemia, hypothyroidism. Hereditary hemolytic disorders such as spherocytosis or G6PD deficiency (X-linked with variable phenotype)

Question 14

Most infants that have Jaundice have what conditions?

Answer 14

Physiological or breast-feeding; Go away by the third week