NURS 629 Exam 4 with Verified Solutions Graded A+ Already
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Course
NURS 629
Institution
NURS 629
NURS 629 Exam 4 with Verified Solutions Graded A+ Already
1. What is physiological jaun-
dice?
2. What level is conjugated hy-
perbilirubinemia?
3. What is breastfeeding jaun-
dice?
4. How do you diagnose jaun-
dice?
-occurs when baby accumulates bilirubin
-secondary to immature liver in ...
NURS 629 Exam 4 with Verified S olutions Graded A+ Already 1. What is physiological jaun- dice? 2. What level is conjugated hy- perbilirubinemia? 3. What is breastfeeding jaun- dice? 4. How do you diagnose jaun- dice? -occurs when baby accumulates bilirubin -secondary to immature liver in newborns -Risk factor is prematurity serum conjugated bilirubin concentration greater than 1 mg/dL if the total bilirubin is less than 5.0 mg/dL or more than 20% of the total bilirubin if the the total bilirubin is greater than 5 mg/dL (p. 862 AAP book) -due to poor intake that causes lack of stools and urine output -common in first week and resolves once milk comes in and infant is feeding well-more stools and urinary output -peaks around 2-3 weeks -dx with a bili level of 5 mg/dL -12 mg/dL threshold for all newborns having jaundiced appearance -direct/indirect bili levels -CBC -reticulocyte count -use of bilitool.org 5. How do you treat jaundice? increased intake, longer feeding indirect sunlight phototherapy IV fluids Bili lights Biliblanket NURS 629 Exam 4 with Verified S olutions Graded A+ Already 6. What are other causes of jaundice? abnormal blood cell shapes (like sickle cell) Rh incompatibility cephalohematoma polycythemia (increased RBCs, SGA infants, twins) infection specific enzyme disorders 7. What is biliary atresia? -life-threatening condition causing a blockage of bile ducts inside or outside of liver -leads to build -up of toxins (like bilirubin) -malabsorption of fat-soluble vitamins A,D,E,K -scaring of the liver, loss of tissue, cirrhosis -not inherited 8. What are the two types of biliary atresia? 9. What causes biliary atre - sia? 10. What are symptoms of bil - iary atresia? fetal- noted in womb (other defects like heart, spleed, intestines) perinatal - appears 2-4 weeks after birth -infection after birth (cytomegalovirus or ro - tavirus) -autoimmune disorder -developmental issue in womb -exposure to toxic substances jaundice dark urine light to white stools poor wt gain and growth 11. How do you diagnose biliary atresia? 12. How do you treat biliary atresia? 13. What are risk factors for de- hydration? 14. What are s/sx of dehydra - tion? 15. How do you treat dehydra - tion? any infant with jaundice present 2-3 weeks after birth -direct and indirect serum bilirubin -LFTs -abdominal x-ray -abdominal US -liver bx -surgery (Kasai procedure), small intestine is attached directly to the liver to allow bile to flow into the small intestine bypassing the cys- tic, hepatic, and common bile duct. -liver transplant GI virus NVD -sunken fontanels -tachycardia and decrease cap refill >2-3 sec- onds -decrease urine output is sensitive but non- specific -increase in urine specific gravity -decrease BP - late finding=more than 10% fluid loss -if minimal, mild, moderate - oral rehydration -if severe (drowsy, cold extremities, lethar - gic, sunken/dry eyes, very depressed anterior fontanel, no tears, dry mouth/tongue, very de- creased skin turgor, rapid/sometimes impal - pable pulse, decreased/unrecordable pulse, deep/rapid respiratory rate, markedly reduced urine output) - IV fluids 16. What is emesis? vomiting=symptom must distinguish from regurgitation in infants integrated response to noxious stimuli -coordi - nated by CNS
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