A nurse is assessing a newborn who was born at 35 weeks of gestation and has physiologic jaundice.
Which of the following factors increases the risk of hyperbilirubinemia in this newborn?
Prematurity
Breastfeeding
Asian ethnicity
All of the above.
The Correct Answer is D
All of the above factors increase the risk of hyperbilirubinemia in this newborn. Hyperbilirubinemia is a condition of high levels of bilirubin in the blood that can cause jaundice and brain damage.
Choice A is wrong because prematurity is a risk factor for hyperbilirubinemia, especially in babies born before 38 weeks of gestation. Premature babies have immature livers that are less able to process bilirubin and eliminate it from the body.
Choice B is wrong because breastfeeding is a risk factor for hyperbilirubinemia, particularly in some breast-fed babies who do not get enough milk or calories. Breastfeeding can also cause increased enterohepatic circulation of bilirubin, which means that bilirubin is reabsorbed from the intestines into the bloodstream instead of being excreted in the stool.
Choice C is wrong because Asian ethnicity is a risk factor for hyperbilirubinemia, as some Asian populations have higher rates of glucose-6-phosphate dehydrogenase deficiency, a genetic condition that causes red blood cells to break down more easily and release more bilirubin. Asian infants may also have lower levels of uridine diphosphate glucuronosyltransferase, an enzyme that helps convert bilirubin into a form that can be excreted by the liver.
Normal ranges for bilirubin levels vary depending on the age, weight, and health status of the newborn. Generally, bilirubin levels peak between the third and seventh day after birth and then decline gradually. The AAP recommends using a nomogram based on the infant’s age in hours and serum bilirubin level to determine the risk of severe hyperbilirubinemia and the need for treatment. Treatment options include phototherapy and exchange transfusion.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Increased oxygen saturation.This indicates that the condition is improving because it means that the blood is getting more oxygen in the lungs and less blood is shunting from the aorta to the pulmonary artery through the patent ductus arteriosus (PDA).
Choice A is wrong because decreased heart rate can be a sign of hypoxia, acidosis, or heart failure, which are complications of PDA.
Choice B is wrong because increased blood pressure can be a sign of increased systemic vascular resistance, which can result from decreased tissue perfusion due to PDA.
Choice C is wrong because decreased respiratory rate can be a sign of respiratory depression, which can be caused by some medications used to treat PDA, such as indomethacin or ibuprofen.
Normal ranges for oxygen saturation in preterm infants are between 88% and 95%.
Normal ranges for heart rate in preterm infants are between 120 and 160 beats per minute.
Normal ranges for blood pressure in preterm infants depend on gestational age and weight.
Normal ranges for respiratory rate in preterm infants are between 40 and 60 breaths per minute.
Correct Answer is A
Explanation
Absent Moro reflex on the affected side indicates a possible injury to the brachial plexus, which is the nerve network that controls the movements and sensations of the shoulder, arm, hand and fingers.Shoulder dystocia can cause brachial plexus injuries when the baby’s shoulder gets stuck behind the mother’s pubic bone during delivery.
Choice B is wrong because flaccid paralysis of both lower extremities is not a common complication of shoulder dystocia.
It could be a sign of spinal cord injury or other neurological disorders.
Choice C is wrong because facial asymmetry when crying or smiling is a sign of facial nerve palsy, which can occur due to compression of the facial nerve during delivery.
It is not specific to shoulder dystocia.
Choice D is wrong because inability to suck or swallow is not a typical sign of shoulder dystocia.
It could be caused by other factors such as prematurity, neurological problems, or congenital anomalies.
Normal ranges for Moro reflex are present at birth and disappear by 4 to 6 months of age.
Normal ranges for facial nerve function are symmetrical movements of both sides of the face.
Normal ranges for sucking and swallowing are coordinated and effective feeding within the first hour after birth.
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