Term
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Definition
| clinical sign of hyperbilirubinemia |
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Term
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Definition
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Term
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Definition
| loose connective tissues in wich fat accumulates |
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Term
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Definition
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Term
| places bilirubin becomes deposited resulting in jaundice |
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Definition
| subcutaneous (skin) and adipose (fat) tissues and the sclera (whites of eyes) |
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Term
| onset of pathological jaundice |
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Definition
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Term
| onset of physiologic jaundice |
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Definition
onset: 48-72 hours
peak: day 3-5 |
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Term
| normal physiologic jaundice bili levels |
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Definition
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Term
| % of babies with exaggerated physiologic jaundice |
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Definition
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Term
| reasons for exaggerated physiologic jaundice |
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Definition
-breastfeeding not well established
-small, weak baby
-late preterm 35-37 weeks
-caloric deprivation |
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Term
| other names for exaggerated physiologic jaundice |
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Definition
-Breastfeeding Associated Jaundice
-Lack of Breastfeeding Jaundice
-Starvation Jaundice
-Breastfeeding Jaundice
-Non-Breastfeeding Jaundice |
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Term
| Onset of Breastmilk Jaundice |
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Definition
Onset: 5-10 days
Peak: day 15 + |
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Term
| % of babies with Breastmilk Jaundice |
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Definition
| 1-2 % of breastfed babies |
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Term
| amount of time a Breastmilk Jaundice baby can remain jaundice for |
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Definition
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Term
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Definition
-indirect reacting
-insoluble in water
-must be converted into conjugated form to be excreted
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Term
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Definition
-direct reacting
-water soluble, non-toxic
-excretable via stool |
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Term
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Definition
60% ft infants
80% premies
-most common physiologic problem in newborns |
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Term
| causes of increased production/presence of bilirubin beyond what the liver can metabolize |
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Definition
1. Hemolysis
2. Polycythemia
3. Birth trauma with resultant bruising |
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Term
| hemolysis and it's causes |
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Definition
a rapid break down of RBCs
caused by
-ABO/Rh incompatibility
-RBC disorders (spherocytosis, G6PD deficiency |
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Term
| polycythemia and it's causes |
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Definition
excess RBCs
due to placenta-to-infant or twin-to-twin transfusion |
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Term
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Definition
| a collection of blood under the scalp of a newborn; caused by pressure during birth |
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Term
| interference with liver's capability to metabolize bilirubin |
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Definition
1. lack of needed enzymes caused by genetic varients/disorders of conjugation (Gilber syndrome)
2. hypothyroidism
3. genetic mutations |
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Term
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Definition
-overly thick meconium clogging intestines
-sign of cystic fibrosis
-causes poor excretion of bilirubin |
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Term
6 maternal factors contributing to hyperbilirubinemia |
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Definition
1. diabetes and hormonal disorders
2. breast abnormalities
3. breast surgury
4. retained placenta
5.hypertension/preeclampsia
6. mother-infant separation |
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Term
| labor and delivery factors |
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Definition
1. epidural leading to increased use of forceps/vacuum extraction
2. birth injury or trauma with resultant bruising |
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Term
| steps for LC approaching jaundice infant |
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Definition
1. quick appraisal- determine if medical intervention is immediately needed
2. History, infant, maternal, and feeding |
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Term
| steps for quick appraisal of jaundice infant |
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Definition
1. lethargic
2. refusal to feed
3. excessive weight loss (> 10%)
4.vomiting
5. inadequate diaper count
6. visible jaundice in first 24 hours or extending below the shoulders at any time |
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Term
| 4 steps for assessing infant history |
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Definition
1. presence of risk factors (RBC disorders, hypothyroidism, genetic disorders, etc)
2. known bili level and associated risk based on AAP risk nomogram
3. color of urine and presence uric acid crystals
4. infant behavior over past 24-48 hours
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Term
5 steps for assessing maternal history
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Definition
1. underlying risk factors (diabetes, retained placenta, hypertension)
2. breast health history (surgery, anatomical abnormality)
3. evidence of breast changes (lactogenisis II)
4. breast/ nipple pain
5. evidence of MER |
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Term
| 4 steps for assessing feeding history |
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Definition
1. frequency of feeds
2. duration of feeds
3. swallows
4. number of voids and stools per 24hrs |
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Term
| diaper count- first 24 hours |
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Definition
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Term
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Definition
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Term
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Definition
4-6 wet
transitional stools |
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Term
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Definition
4-6 wet
transitional stools |
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Term
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Definition
6 + wet
3-4 yellow stools |
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Term
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Definition
1. capillary refill longer than 2 seconds
2. poor skin turgor
3. dry mucus membranes
4. sunken fontenel |
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Term
| physical assessment of infant |
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Definition
1. general apperance
2. evidence of dehydration
3. oral-facial abnormalities
4.current weight and percentage of weight loss
5. visual assessment of extent of jaundice
6. visible bruising |
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Term
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Definition
1. latch on
2. swallows
3. impact of position change
4. possibly do a test weight (>8% loss) |
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Term
| early signs of kernicterus |
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Definition
-lethargy
-poor feeding
-listlessness
-loss of moro reflex |
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Term
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Definition
-hearing loss
-rigid arching
-bulging fontanels
-seizures |
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Term
| two types of bilirubin testing |
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Definition
1. serum (blood) bili test- heel sticks
2. TcB (trans-cutaneous bilirubin) hand held devices- non invasive |
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