HYPERBILIRUBINEMIA

Question 1

• Refers to an excessive level of accumulated bilirubin in the blood
• Characterized by jaundice or icterus
• Common finding in the newborn but in extreme cases, it can indicate
  a pathologic state.
• It may result from increased unconjugated or conjugated bilirubin

Answer 1

hyperbilirubinemia

Question 2

possible causes

Answer 2

• physiologic
• breastfeeding
• excess bilirubin
• liver cant secrete conjugated bil
• overproduction and under excretion
• genetics

Question 3

complications

Answer 3

bilirubin encephalopathy
kernicterus

Question 4

• a common and typically harmless condition in newborns where the skin and eyes turn yellow due to elevated bilirubin levels in the blood
• most common evidence of hyperbilirubinemia

Answer 4

physiologic jaundice

Question 5

what phase

bilirubin levels of formula fed infants gradually increase
to approximately 5-6 mg/dl by 2 or 5 days of life then decrease to a
plateau of less than 3 mg/dl by the 5th day

Answer 5

first phase

Question 6

what phase

:bilirubin maintain a steady plateau without increasing
or decreasing until approximately 12-14 days at which levels
decrease to the normal value of 1 mg/dl

Answer 6

second phase

Question 7

if it appears within the 1st 24 hours and is caused
by HDN, sepsis or one of the maternally derived diseases such
as diabetes mellitus or infections

Answer 7

pathologic

Question 8

if it appears on the 2nd or 3rd day, peaks on the
3rs to 5th day, and declines on the 5th to 7th day

Answer 8

physiologic

Question 9

normal value of unconjugated bilirubin

Answer 9

0.2-1.4 mg/dl

Question 10

risk factors in term and late preterm

Answer 10

• jaundice within 24 hours after birth
• serum bilirubin high
• rh incompatibility
• hemolytic disease (g6pd)
• ges age 35-36 weeks
• east asian or asian american race
• cephalhematoma
• exclusive BF
• hx of sibling with hyperbilirubinemia

Question 11

therapeutic mgmt

Answer 11

a. Phototherapy
b. Exchange transfusion
c. Pharmacologic treatment – Phenobarbital
d. Early initiation of feedings
e. Frequent breastfeeding

Question 12

primary goal

Answer 12

prevent bilirubin encephalopathy and kernicterus

Question 14

encourage frequent BF preferably every ___ hours

Answer 14

1.5 - 2 hours

Question 15

this screening tool is now widely used in newborn nurseries and outpatient clinics, offices, and emergency departments to obtain a rapid and non-invasive estimate of the degree of hyperbilirubinemia

Answer 15

transcutaneous bilirubin meter