Newborn Physiologic Adjustments (Hepatic System)

Question 1

Within the first week infants should be approximately ______ Glucose level.

Answer 1

60 to 80

Question 2

In general blood glucose levels less than _____ are considered abnormal and warrant intervention.

Answer 2

40

Question 3

The hypoglycemic infant can display the classic symptoms:

Answer 3

Jitteriness
Lethargy
Apnea
Feeding problems
Seizures

Question 4

What is a description of jaundice?

Answer 4

The visible yellowish color of the skin and sclera.

Question 5

What causes jaundice?

Answer 5

By the elevated serum levels of unconjugated (indirect) bilirubin.

Question 6

Feeding is important in reducing serum bilirubin levels b/c

Answer 6

it stimulates peristalsis and produces more rapid passage of meconium, thus diminishing the amount of reabsorption of unconjugated bilirubin.

Question 7

When does jaundice appear?

Answer 7

When levels of unconjugated bilirubin exceed the ability of the liver to conjugate it, resulting in plasma levels of bilirubin increase.

Question 8

How is the degree of jaundice determined?

Answer 8

Determined by serum total bilirubin measurements.

Question 9

Jaundice is likely to appear when bilirubin levels exceed?

Answer 9

5 to 6

Question 10

Traditionally, newborn jaundice has been categorized into what two categories?

Answer 10

Physiologic

pathologic

Question 11

What determine the category of jaundice?

Answer 11

Depending primarily on the time it appears and on serum bilirubin levels.

Question 12

What affects total serum bilirubin levels in newborns?

Answer 12

Length of gestation
Age
Weight
Race
Nutritional Status
Mode of feeding

Question 13

What is the key factor in evaluating the cause and determining if treatment is needed for jaundice?

Answer 13

The time of onset

Question 14

What is the most significant factor that increases the risk of hyperbilirubinemia?

Answer 14

Prematurity

Question 15

What ethnicities have the higher bilirubin levels?

Answer 15

Asian and Native american

Question 16

Do breastfeeding or bottle fed infants have a higher risk of hyperbilirubinemia?

Answer 16

Breastfeed

Question 17

When does physiologic or non pathologic jaundice usually appear?

Answer 17

24 hrs after birth.

Usually resolves without treatment

Question 18

When is jaundice considered pathologic or non physiologic?

Answer 18

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.

Question 19

What happens if increased levels of unconjugated bilirubin is left untreated?

Answer 19

Neurotoxicity can result as bilirubin is transferred into the brain cells.

Question 20

What does acute bilirubin encephalopathy refer to?

Answer 20

The acute manifestations of bilirubin toxicity that occur during the first weeks after birth.

Question 21

What are symptoms of acute bilirubin encephalopathy?

Answer 21

Lethargy
Hypotonia
Irritability 
Seizures
Coma
Death

Question 22

What does kernicterus refer to?

Answer 22

The irreversible, long-term consequences of bilirubin toxicity such as:
Hypotonia 
Delayed motor skills
Hearing loss
Cerebral palsy 
Gaze abnormalities

Question 23

What does the administration of vitamin K do?

Answer 23

Helps prevent clotting problems

Question 24

When do newborns obtain the same level of Vitamin K as adults?

Answer 24

9 months of age

Question 25

Why must circumcised babies need to be monitored closely?

Answer 25

Because infants can develop a coagulation deficiency.