Newborn Physiologic Adjustments (Hepatic System) Flashcards
Within the first week infants should be approximately ______ Glucose level.
60 to 80
In general blood glucose levels less than _____ are considered abnormal and warrant intervention.
40
The hypoglycemic infant can display the classic symptoms:
Jitteriness Lethargy Apnea Feeding problems Seizures
What is a description of jaundice?
The visible yellowish color of the skin and sclera.
What causes jaundice?
By the elevated serum levels of unconjugated (indirect) bilirubin.
Feeding is important in reducing serum bilirubin levels b/c
it stimulates peristalsis and produces more rapid passage of meconium, thus diminishing the amount of reabsorption of unconjugated bilirubin.
When does jaundice appear?
When levels of unconjugated bilirubin exceed the ability of the liver to conjugate it, resulting in plasma levels of bilirubin increase.
How is the degree of jaundice determined?
Determined by serum total bilirubin measurements.
Jaundice is likely to appear when bilirubin levels exceed?
5 to 6
Traditionally, newborn jaundice has been categorized into what two categories?
Physiologic
pathologic
What determine the category of jaundice?
Depending primarily on the time it appears and on serum bilirubin levels.
What affects total serum bilirubin levels in newborns?
Length of gestation Age Weight Race Nutritional Status Mode of feeding
What is the key factor in evaluating the cause and determining if treatment is needed for jaundice?
The time of onset
What is the most significant factor that increases the risk of hyperbilirubinemia?
Prematurity
What ethnicities have the higher bilirubin levels?
Asian and Native american
Do breastfeeding or bottle fed infants have a higher risk of hyperbilirubinemia?
Breastfeed
When does physiologic or non pathologic jaundice usually appear?
24 hrs after birth.
Usually resolves without treatment
When is jaundice considered pathologic or non physiologic?
If it appears within 24 hrs of birth, if total serum bilirubin levels increase by more than 6 mg in 24 hrs, and if the serum bilirubin level exceeds 15 mg.
What happens if increased levels of unconjugated bilirubin is left untreated?
Neurotoxicity can result as bilirubin is transferred into the brain cells.
What does acute bilirubin encephalopathy refer to?
The acute manifestations of bilirubin toxicity that occur during the first weeks after birth.
What are symptoms of acute bilirubin encephalopathy?
Lethargy Hypotonia Irritability Seizures Coma Death
What does kernicterus refer to?
The irreversible, long-term consequences of bilirubin toxicity such as: Hypotonia Delayed motor skills Hearing loss Cerebral palsy Gaze abnormalities
What does the administration of vitamin K do?
Helps prevent clotting problems
When do newborns obtain the same level of Vitamin K as adults?
9 months of age
Why must circumcised babies need to be monitored closely?
Because infants can develop a coagulation deficiency.
