newborn complications

Question 1

hyperbilirubmia is caused by

Answer 1

not enough albumin
bilirubin escaping liver

Question 2

what is bilirubin

Answer 2

yellow bile pigment produced by the breakdown of rbc

Question 3

function of albumin

Answer 3

transport bilirubin
prevent bilrubin from escaping into vascular space and prevents it from being into tissues

Question 4

what takes bilrubin to liver

Answer 4

albumin

Question 5

how does bilirubin get in liver

Answer 5

disffuse and endocytosis

Question 6

what makes bilirubin soluble

Answer 6

glucuronyl transferase
- congualted

Question 7

why cant bilirubun be reabsorbed once its cogugated

Answer 7

it gets bigger

Question 8

issues with NB that cause jaundice

Answer 8

immature livers
faulty process
binding sites are low in supply

Question 10

what gives yellow colour

Answer 10

biliruin getting into tissues

Question 11

billirubin in brain

Answer 11

neurotoxicity

Question 12

what needs to be working well to prevent too much bilirubin issues

Answer 12

GI, get bilirubin leaving! encourage bf

Question 13

what is a natural laxtive that helps pass mecomin

Answer 13

colotrsum

Question 14

how is bilirubin made

Answer 14

breakdown of HEME

Question 15

lifespan of neonatal RBC

Answer 15

shorter than adults

Question 16

what causes increase bilirubin production in NB

Answer 16

more RBC/ Hb made due to shorter lifespan?

Question 17

what infants get polycythemia

Answer 17

diabetic mothers babies

Question 18

when are bilirubin levels checked

Answer 18

24-72hrs after birth

Question 19

how does jaundice move

Answer 19

down the body, head to down , in sclera

Question 20

physiological jaundice appears when and resolves

Answer 20

• AFTER 24 HRS AGE
• without treamtent mostly

Question 21

pathological jaundice (time)

Answer 21

within 24 hour of age

Question 22

reasons for physiplogical jaundice

Answer 22

• high rbc mass, short lifepsan
• reduce abilty of liver to conjugate
  -fewer bilirubin bindings sites
• conugated changes in unconjugates in intestine

Question 23

what number means hyperbilirubinemia

Answer 23

more than 340 in the first 28 days of life? or less

Question 24

does bilirubin cross BBB

Answer 24

yes

Question 25

kernicterus is

Answer 25

long term
- irreversible consequence of bilirubin toxciity
cant undo

Question 26

signs and symtpms of encephalopathy

Answer 26

lethargy
hypotonia
irrtiabilty
seziures
coma
death

Question 27

what can cause bilirubin to displace from albumin

Answer 27

cold tress or asphyixa

Question 28

what race pop has higher risk of hyperbilurbinemia

Answer 28

asian and indigenous babies

Question 29

what gender baby is more likely to get hyperbili

Answer 29

boy babies

Question 30

how to check for jaundice

Answer 30

• press done on forehead (bony prominece) can see jaundice in between
  darkskinned babies: sclera and mucos membrane
• natural light

Question 31

reducing risk of jaundice

Answer 31

-early bf
- feed frequent
- avoid glucose water (dont wanna take up space)
- meconim water

Question 32

transcutaneous bilirubin screening

Answer 32

• checking bilirubin levels
• tale three readings and take avg
• first 72 hrs of life or earlier
• can do same time as metabolic screening

Question 33

when are Tcb more accurate

Answer 33

before the start of phototherapy
lower levels??

Question 34

checking for bilirubin if mom is rh-

Answer 34

direct antiglobunin test or Coombs test

Question 35

first line of treatment of hyperbilirub

Answer 35

phototherapy

Question 36

how often should infant with hyperbilrubin be weighed

Answer 36

every day

Question 37

why is it important to assess skin turgor for baby in phototherapy

Answer 37

hydration status

Question 38

can you put oily substance on baby on phototherapy

Answer 38

no

Question 39

why are babies more prone to heat loss

Answer 39

bv closer to skin
large surface to body ratio

Question 40

what is brown fat rich in

Answer 40

rich in blood supply

Question 41

can babies make more brown fat once its gone

Answer 41

no

Question 42

non shivering thermogenesis

Answer 42

• brown fat user

Question 43

where does metabolic actvity increase during cold

Answer 43

liver and brain

Question 44

evaporation

Answer 44

had bath, not dried right away, water evaporates and takes thier heat

Question 45

conduction

Answer 45

on cool surface

Question 46

convection

Answer 46

cool air flowing near them

Question 47

radiation

Answer 47

near a window during winter time

Question 48

when is non shivering thermogensis triggered

Answer 48

35-36 C

Question 49

effects of cold stress

Answer 49

hypoglucemic
met acidosis
resp distress
used brownf ats
less activtyL hypotonia
peripheral vc

Question 50

babies with sepsis

Answer 50

pale
hands and feet are cool

Question 51

hypoglycemia numbers

Answer 51

less than 2.6

Question 52

do healthy abbies need glucose screening

Answer 52

no

Question 53

3rd day glucose number in NB

Answer 53

4-6mmol/L

Question 54

what makes NB at risk for hypoglycemia

Answer 54

• moms with diabetes
  gest hypertension
• small of gest, large
  preterm
  cold stress
  infection
  any other stress
  congential issues
  hyperthermia
  polycythemia

Question 55

when to measure glucose for babies with risk factors for hypoglyecmiea

Answer 55

2 hrs after birth and every 3-6 afters
- intial check one breast feeding

Question 56

clincal manisfestions of NB hypoglycemia

Answer 56

jittery
cyanosis
weakcry
high pitched cry
poor feeding
hypotonia
temp isntablity
resp dispress
apnea
seixures

Question 57

when to discontuen bg checking

Answer 57

if stable for 24 hrs
at 2.6 or more mmol/L

Question 58

really hypoglycemic babies

Answer 58

give IV dextrose