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Questions and Answers
What is the primary cause of hyperbilirubinemia?
Which of the following is a physiologic factor that can cause hyperbilirubinemia?
Which of the following is NOT a risk factor for hyperbilirubinemia?
What is bilirubin a breakdown product of?
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Which of the following conditions is NOT listed as a cause of hyperbilirubinemia?
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Which of the following is a criterion indicative of pathologic jaundice?
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What is the primary cause of Meconium Aspiration Syndrome?
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Which of the following is a common clinical manifestation of Meconium Aspiration Syndrome in newborns?
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How can Meconium Aspiration Syndrome be diagnosed?
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Which of the following is a potential complication of severe Meconium Aspiration Syndrome?
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What is a common therapeutic management approach for Meconium Aspiration Syndrome immediately after birth?
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How does hypoxic stress contribute to the development of Meconium Aspiration Syndrome?
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What is the purpose of administering surfactant in Respiratory Distress Syndrome treatment?
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What is the role of the nurse in the administration of surfactant?
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What is the content of meconium that can lead to Meconium Aspiration Syndrome?
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What can stimulate the release of meconium into the amniotic fluid in Meconium Aspiration Syndrome?
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What is a complication associated with surfactant administration in Respiratory Distress Syndrome treatment?
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Why might suctioning be delayed after surfactant administration?
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Study Notes
Hyperbilirubinemia
- Characterized by jaundice resulting from increased unconjugated or conjugated bilirubin
- Bilirubin is a breakdown product of hemoglobin from RBC destruction
- Causes:
- Physiologic factors – prematurity
- Association with breastfeeding or inadequate breast milk
- Excess production of bilirubin – hemolytic disease, biochemical defects, bruises
- Disturbed capacity of the liver to secrete conjugated bilirubin
- Combined overproduction and underexcretion
- Conditions or diseases (G6PD, deficiency, hypothyroidism, galactosemia, infant with diabetic mother)
- Genetic predisposition to increased production (native American, Asians)
- Risk factors:
- Maternal race
- Late preterm birth
- Jaundice observed in the first 24 hours of life
- Significant bruising
- Cephalhematoma
- Exclusive breastfeeding
- Blood group incompatibility or hemolytic disease such as G6PD
- History of sibling with hyperbilirubinemia
Meconium Aspiration Syndrome
- Pathophysiology:
- Hypoxic stress causes passage of meconium in utero
- Fetus ingest meconium into the lower airways
- Air trapped due to obstruction of meconium
- Hyperinflation distal to the obstruction lead to Atelectasis due to deactivation of surfactant (Hypoxemia, hyperinflation, acidemia)
- Clinical manifestations:
- Tachypnea, retractions, expiratory grunting
- Nasal flaring
- Cyanotic or pale
- Barrel chest from hyperinflation
- Stressed, hypothermic
- Hypoglycemic and hypocalcemic
- Diagnostic evaluation:
- Laryngoscopy to visualize the respiratory passages and vocal cords
- Chest radiographs show uneven distribution of patchy infiltrates, air trapping, hyper expansion, and atelectasis
- Air leaks may occur as the illness progresses
- Therapeutic management:
- Tracheal suctioning based on infant assessment after birth
- Administration of surfactant
Respiratory Distress Syndrome
- Treatment:
- Administration of surfactant (Beractant, Poractant, Calfactant)
- Complications: Pulmonary hemorrhage and mucus plugging
- Nursing responsibilities:
- Assist in the delivery of the product
- Collect and monitor ABG
- Monitor oxygenation
- Assess infant's tolerance of the procedure
- Surfactant absorption increases respiratory compliance, requiring adjustment of the ventilator
- Suctioning delayed for an hour depending on the type of surfactant and delivery system
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Description
Test your knowledge on hyperbilirubinemia, its causes, and the associated physiological factors like prematurity and breastfeeding. Learn about the signs of complications such as meningitis and septic shock.
