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    Hyperbilirubinemia Final Paper

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    This paper discusses hyperbilirubinemia, or jaundice, in newborns. It is common and usually benign, caused by the immaturity of an infant's liver and high bilirubin production. More severe cases can be caused by blood incompatibilities between mother and baby. Treatment involves phototherapy or exchange transfusions to prevent brain damage from bilirubin toxicity. Nurses monitor jaundice levels and educate parents on signs, treatments, and ensuring infant well-being.

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    Hyperbilirubinemia Final Paper

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    This paper discusses hyperbilirubinemia, or jaundice, in newborns. It is common and usually benign, caused by the immaturity of an infant's liver and high bilirubin production. More severe cases can be caused by blood incompatibilities between mother and baby. Treatment involves phototherapy or exchange transfusions to prevent brain damage from bilirubin toxicity. Nurses monitor jaundice levels and educate parents on signs, treatments, and ensuring infant well-being.

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    This paper discusses hyperbilirubinemia, or jaundice, in newborns. It is common and usually benign, caused by the immaturity of an infant's liver and high bilirubin production. More severe cases can be caused by blood incompatibilities between mother and baby. Treatment involves phototherapy or exchange transfusions to prevent brain damage from bilirubin toxicity. Nurses monitor jaundice levels and educate parents on signs, treatments, and ensuring infant well-being.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    42 views5 pages

    Hyperbilirubinemia Final Paper

    Uploaded by

    api-544185261
    This paper discusses hyperbilirubinemia, or jaundice, in newborns. It is common and usually benign, caused by the immaturity of an infant's liver and high bilirubin production. More severe cases can be caused by blood incompatibilities between mother and baby. Treatment involves phototherapy or exchange transfusions to prevent brain damage from bilirubin toxicity. Nurses monitor jaundice levels and educate parents on signs, treatments, and ensuring infant well-being.

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    of 5

    Running head: HYPERBILIRUBINEMIA 1

    Shelby Robison

    Jackson College

    NRS 211: Care of Women and Neonates


    HYPERBILIRUBINEMIA 2

    Abstract

    This paper will help you understand more about hyperbilirubinemia and how it effects the

    newborn baby. Hyperbilirubinemia continues to be one of the main concerns when caring for

    newborns and has multiple causes. Long term effects are rare due to our highly effective

    treatment options. All infants, especially pre-term, are at risk for developing hyperbilirubinemia.

    Assessments of the skin will be made routinely, along with total serum bilirubin levels.

    Screening is done on all infants in the hospital after birth. Our treatments have advanced

    dramatically, but continuing education is still important.


    HYPERBILIRUBINEMIA 3

    Hyperbilirubinemia presents as jaundice skin and is a common concern when caring for

    neonates. Elevated bilirubin levels are present and are considered to be physiological or non-

    physiological. Physiologic jaundice is considered normal. It is caused by transient

    hyperbilirubinemia and is not present during the first 24 hours of life but appears two to three

    days after birth. (McKinney, James, Murray, Nelson, & Ashwill, 2018, p. 432) Non-physiological

    jaundice can be seen within the first 24 hours and is caused by destruction of red blood cells or

    problems with bilirubin conjugation. Infants, especially preterm, have a higher rate of bilirubin

    production than adults because their red blood cell life span is shorter. Unconjugated bilirubin is

    not readily excreted, and the ability to conjugate bilirubin is limited. (Dennery, Seidman, &

    Stevenson, 2001)

    The most common cause of pathologic jaundice is hemolytic disease which results from

    blood incompatibility between the mother and the fetus, also known as Rh incompatibility. An

    Rh-negative mother forms antibodies when Rh-positive blood from the fetus enters her

    circulation. These antibodies can develop in prior pregnancies, abortions, amniocentesis, or a

    transfusion of Rh-positive blood. The antibodies can cross the placenta and destroy the fetal red

    blood cells, causing erythroblastosis fetalis, a condition caused by agglutination and hemolysis of

    fetal erythrocytes. (McKinney, James, Murray, Nelson, & Ashwill, 2018, p. 645) RhoGAM is a

    Rho globulin that is given to the mother and inhibits the production of Rh-positive antibodies to

    prevent erythroblastosis fetalis. ABO incompatibly also causes pathologic jaundice. Mothers

    with type O blood have natural antibodies to types A and B blood. Hemolysis can occur when

    these antibodies cross the placenta, but the destruction is much less severe than with Rh

    incompatibility. (McKinney, James, Murray, Nelson, & Ashwill, 2018, p. 645)


    HYPERBILIRUBINEMIA 4

    Non-physiologic jaundice is a concern because it can lead to bilirubin encephalopathy, a

    condition caused by bilirubin toxicity. Kernicterus can also occur which is chronic and/or

    permanent with effects of bilirubin toxicity. In kernicterus bilirubin stains the brain a yellow

    color, specifically the basal ganglia, cerebellum, hippocampus, and brainstem. (McKinney,

    James, Murray, Nelson, & Ashwill, 2018, p. 645) The mortality and morbidity rate of kernicterus

    and bilirubin encephalopathy is high, but both of these conditions are rare. Long term

    consequences when somebody survives these conditions are cerebral palsy, intellectual

    impairment, hearing loss, and other neurologic and developmental problems.

    Phototherapy is the standard of care for treating hyperbilirubinemia. Efficient

    phototherapy will rapidly reduce serum bilirubin. (Dennery, Seidman, & Stevenson, 2001) The

    bilirubin in the skin is absorbed by the light and converts into water-soluble products called

    lumirubin. Lumirubin does not require conjugation by the liver and can be excreted in the bile

    and urine. Exchange transfusions are only used when phototherapy cannot reduce high bilirubin

    levels. Small portions of blood are removed and replaced with an equal amount of donor blood.

    At the end of the procedure, roughly 85% of the red blood cells have been replaced. (McKinney,

    James, Murray, Nelson, & Ashwill, 2018, p. 646)

    The nurse should assess the infant’s level of jaundice at least every 8 hours by pressing

    over a bony prominence and noting the color. This assessment should be done when

    phototherapy lights are off. Other important nursing interventions include maintaining a neutral

    thermal environment, providing optimal nutrition, protecting the eyes, enhancing response to

    therapy, detecting complications, and teaching parents. (McKinney, James, Murray, Nelson, &

    Ashwill, 2018, p. 646) New parents will have lots of questions, so education is the key for the

    nurse!
    HYPERBILIRUBINEMIA 5

    References

    Dennery, P. A., Seidman, D. S., & Stevenson, D. K. (2001, February 22). Neonatal

    Hyperbilirubinemia: NEJM. Retrieved April 16, 2020, from

    https://www.nejm.org/doi/full/10.1056/NEJM200102223440807

    McKinney, E. S., James, S. R., Murray, S. S., Nelson, K. A., & Ashwill, J. W.

    (2018). Maternal-child nursing. St. Louis, MO: Elsevier.

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