Welcome to Episode 104
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Tip of The Week- Care and Interventions of Newborn Jaundice
Most preterm and almost 50% of full term newborns present with jaundice, a yellow discoloration of the skin and sclera of the eyes. The yellowish hue comes from bilirubin, a substance produced from break down of red blood cells, when it reaches a blood level greater than approximately 2.5 mg/dL. This bilirubin is excreted in the stool via the liver, in the case of infants, this process takes more time resulting to accumulation in the skin. Jaundice appearing about 2-3 days after birth, called physiologic jaundice is normal in newborns,however, interventions like phototherapy should be instituted to help the infant’s body excrete the excess bilirubin.
There are also disorders that can cause bilirubin levels to increase in newborns like blood type incompatibilities, prematurity, polycythemia, etc. If left unresolved, bilirubin may continually increase and cause serious complications such as cerebral palsy, deafness, and kernicterus ( brain damage from very high bilirubin levels).
Infants receiving phototherapy, the first line intervention for jaundice, requires special attention to avoid chilling or burning of the skin. Intake and output should be monitored and carefully documented, including continuous assessment for skin breakdown and bilirubin lab values should always be updated. Serum bilirubin levels above 25 mg/dL or higher at any time is a medical emergency and the infant should be evaluated immediately for exchange transfusion.
For more on nursing care of newborn jaundice, follow links below
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Other Podcasts from Jamie Davis:
- The MedicCast (for EMTs, Paramedics, EMS field work)
- MedicCast News (Weekly short medical news program)
- MedicCast Live (Monthly live call-in show with a single EMS topic)
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This week- “Wednesday Morning” by Slackstring
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