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NURS 629 Exam 4 Graded And Verified By An Expert
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NURS 629 Exam 4 Graded And Verified By An ExpertHow do you treat jaundice? - Correct Answer-increased intake, longer feeding
indirect sunlight
phototherapy
IV fluids
Bili lights
Biliblanket
What are other causes of jaundice? - Correct Answer-abnormal blood cell shapes (like sickle
cell)
Rh incompatibility
cephalohematoma
polycythemia (increased RBCs, SGA infants, twins)
infection
specific enzyme disorders
What is biliary atresia? - Correct Answer--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
What are the two types of biliary atresia? - Correct Answer-fetal- noted in womb (other
defects like heart, spleed, intestines)
perinatal- appears 2-4 weeks after birth
What causes biliary atresia? - Correct Answer--infection after birth (cytomegalovirus or
rotavirus)
-autoimmune disorder
-developmental issue in womb
-exposure to toxic substances
What are symptoms of biliary atresia? - Correct Answer-jaundice
dark urine
light to white stools
poor wt gain and growth
How do you diagnose biliary atresia? - Correct Answer-any infant with jaundice present 2-3
weeks after birth
-direct and indirect serum bilirubin
,-LFTs
-abdominal x-ray
-abdominal US
-liver bx
How do you treat biliary atresia? - Correct Answer--surgery (Kasai procedure), small
intestine is attached directly to the liver to allow bile to flow into the small intestine
bypassing the cystic, hepatic, and common bile duct.
-liver transplant
What is physiological jaundice? - Correct Answer--occurs when baby accumulates bilirubin
-secondary to immature liver in newborns
-Risk factor is prematurity
What level is conjugated hyperbilirubinemia? - Correct Answer-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)
What is breastfeeding jaundice? - Correct Answer--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
, How do you diagnose jaundice? - Correct Answer--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
What are risk factors for dehydration? - Correct Answer-GI virus
NVD
What are s/sx of dehydration? - Correct Answer--sunken fontanels
-tachycardia and decrease cap refill >2-3 seconds
-decrease urine output is sensitive but nonspecific
-increase in urine specific gravity
-decrease BP- late finding=more than 10% fluid loss
How do you treat dehydration? - Correct Answer--if minimal, mild, moderate- oral
rehydration
-if severe (drowsy, cold extremities, lethargic, sunken/dry eyes, very depressed anterior
fontanel, no tears, dry mouth/tongue, very decreased skin turgor, rapid/sometimes
impalpable pulse, decreased/unrecordable pulse, deep/rapid respiratory rate, markedly
reduced urine output) - IV fluids
What is emesis? - Correct Answer-vomiting=symptom
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