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MVU NURS 629 EXAM 4 WITH COMPLETE SOLUTION LATEST UPDATE (A+ exam)

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What is physiological jaundice? - ✔✔-occurs when baby accumulates bilirubin -secondary to immature liver in newborns -Risk factor is prematurity What level is conjugated hyperbilirubinemia? - ✔✔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? - ✔✔-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? - ✔✔-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 How do you treat jaundice? - ✔✔increased intake, longer feeding indirect sunlight phototherapy IV fluids Bili lights BiliblanketWhat 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 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 What are the two types of biliary atresia? - ✔✔fetal- noted in womb (other defects like heart, spleed, intestines) perinatal- appears 2-4 weeks after birth What causes biliary atresia? - ✔✔-infection after birth (cytomegalovirus or rotavirus) -autoimmune disorder -developmental issue in womb -exposure to toxic substances What are symptoms of biliary atresia? - ✔✔jaundice dark urine light to white stools poor wt gain and growth How do you diagnose biliary atresia? - ✔✔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? - ✔✔-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 are risk factors for dehydration? - ✔✔GI virus NVD What are s/sx of dehydration? - ✔✔-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? - ✔✔-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? - ✔✔vomiting=symptom must distinguish from regurgitation in infants integrated response to noxious stimuli-coordinated by CNS What is acute emesis?

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