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Hyperbilirubinemia

Recall hyperbilirubinemia by the hiker-belly-ribbon-dancer. This condition is often seen in newborns and is the result of increased unconjugated bilirubin in the blood, shown by the up-arrow un-conga belly-ribbon-dancer. The characteristic symptom of hyperbilirubinemia is jaundice, illustrated as the jaundice-janitor, which is seen as a yellowing of the skin, sclera, and nails. This condition may lead to the development of bilirubin encephalopathy or kernicterus, portrayed by the colonel with baby. Symptoms of kernicterus include decreased activity, lethargy, irritability, and hypotonia. Because bilirubin is excreted by binding to the stool, early and frequent feedings, represented by the early-sun feeding, can help prevent hyperbilirubinemia by promoting stooling and excretion of bilirubin. To inhibit the enzyme that breaks up heme, heme oxygenase inhibitors may be given, shown by He-man oxygen-ace in inhibiting-chains. Another common intervention is phototherapy, depicted by the photo-camera giving a therapeutic massage. Because the bright light from phototherapy can damage the eyes, eye protection during therapy is crucial, shown by the sunglasses. Phototherapy can also increase the risk of dehydration so be sure to monitor for signs of dehydration to maintain adequate fluid status, shown by the monitor and empty canteen. Lastly, we see the belly-ribbon-dancer tossing the monitor to the floor to remind you to know the normal ranges for bilirubin and to monitor bilirubin levels in newborns with hyperbilirubinemia in order to detect increased levels that may lead to complications. Normal levels of unconjugated bilirubin range between 0.2-1.4 mg/dl. So let&rsquo;s review hyperbilirubinemia. It is most commonly characterized as excessive levels of unconjugated bilirubin in the blood. Jaundice is the primary symptom and toxic levels of bilirubin can lead to kernicterus or bilirubin induced encephalopathy. Interventions include early frequent feedings, administration of heme oxygenase inhibitors, and phototherapy, which requires protecting the eyes and monitoring for dehydration. Monitoring bilirubin levels in newborns with hyperbilirubinemia is critical for detecting increased levels that may lead to complications.

educational

story

hiker belly ribbon dancer.png

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Hiker-belly-ribbon-dancer

Neonatal Jaundice

Neonatal Hyperbilirubinemia (Neonatal Jaundice)

Neonatal jaundice: Clinical practice

Cause/Mechanism

up arrow

Up-arrow Un-conga Belly-ribbon-dancer

Increased Unconjugated Bilirubin

What lab finding is most consistent with an infant suffering from ABO blood type incompatibility?

Assessment

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Jaundice-janitor

Jaundice

A patient with hyperbilirubinemia is most likely to display which of the following signs or symptoms on clinical assessment?

colonel

Colonel 

Kernicterus

A patient with severe hyperbilirubinemia may develop what?

Interventions

early sun

Early-sun Feeding

Early Feedings

Which of the following dietary interventions is most likely to help treat a patient with hyperbilirubinemia?

he man

He-man Oxygen-ace in Inhibiting-chains

Heme Oxygenase Inhibitors

The use of which of the following drug interventions is most likely to help treat a patient with hyperbilirubinemia?

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Photo-flash

Phototherapy

Which of the following treatment modalities is most likely indicated in a patient with moderate hyperbilirubinemia?

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Sunglasses

Protect Eyes

Which of the following is an important consideration in patients with hyperbilirubinemia who are undergoing phototherapy?

monitor

Monitor and Empty-canteen

Monitor for Dehydration

Considerations

Monitor and Belly-ribbon-dancer

Monitor Bilirubin Levels

Which of the following considerations is most critical in patients with hyperbilirubinemia?

First Aid for the USMLE Step 1 2017

First Aid for the USMLE Step 1 2018

Hockenberry, Wong's Nursing Care of Infants and Children, 10th Ed.

Ignatavicius Medical-Surgical Nursing, 9th Edition

Master The Boards USMLE Step 2 CK, 3E

Medical-Surgical Nursing, 10th Ed, Lewis, Dirksen, Heitkemper, & Bucher

Medical-Surgical Nursing, 9th Ed, Lewis, Dirksen, Heitkemper, & Bucher

STEP-UP to USMLE Step 2 CK, 4th Ed

We improved the quiz for this Picmonic with all new questions.

That&rsquo;s it. Enough is enough. It&rsquo;s time for this Belly-ribbon-dancer to go full on hiker! I&rsquo;m going to hike up to the top of this mountain to see this dumb baby that&rsquo;s stealing my spotlight! Used to be that everyone wanted belly-ribbon-dancer to play congas in their commercials but now my agent broke my congas and dropped me. Whatever, he&rsquo;s just a jaundice-janitor anyway. But now that baby is taking all of my roles. First the fried chicken commercial with the colonel now she&rsquo;s filming on top of this stupid mountain. Gah! Almost there.. Wait, what? She gets fed by the early morning sun&nbsp;and she has a He-man slave refresh her with oxygen-ace. Who is her manager? Ugh, she&rsquo;s so much younger and prettier than me. The camera loves her. I hate her! She thinks she&rsquo;s so hot with those sunglasses. &nbsp;I see on the monitor that she&rsquo;s filming a commercial for empty canteens. &ldquo;Is it time to fill your canteen?&rdquo; No. It&rsquo;s time for this belly-ribbon-dancer to break this stupid monitor. Ugh take that stupid baby star!

"My baby must have nothing by mouth 8 hours prior to therapy."

"Aside from a diaper and eye protection, my baby will be completely undressed during therapy."

"Feedings should continue on a regular schedule during therapy."

"This therapy increases the risk of dehydration for my baby."

"This therapy will be used regardless of whether the infant is awake or asleep."

Picmonic uses mnemonics to help you develop NCLEX mastery so you can pass the NCLEX exam the first time. Free question for 10/2021/02

Picmonic NCLEX Question of the Day 10/2021/02

Picmonic NCLEX® Question of the Day

A 3-day-old neonate is diagnosed with hyperbilirubinemia and is ordered for phototherapy sessions. The nurse is providing education about this treatment to the mother. Which of the following statements made by the mother indicates the need for further education?

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