NURS 629 Exam 4 Questions and Solutions 2024/2025

NURS 629 Exam 4 Questions and Solutions 2024 What is physiological jaundice? - Answer --occurs when baby accumulates bilirubin -secondary to immature liver in newborns -Risk factor is prematurity What level is conjugated hyperbilirubinemia? - Answer -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? - Answer --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? - Answer --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 How do you treat jaundice? - Answer -increased intake, longer feeding indirect sunlight phototherapy IV fluids Bili lights Biliblanket What are other causes of jaundice? - Answer -abnormal blood cell shapes (like sickle cell)Rh incompatibility cephalohematoma polycythemia (increased RBCs, SGA infants, twins) infection specific enzyme disorders What is biliary atresia? - Answer --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? - Answer -fetal- noted in womb (other defects like heart, spleed, intestines) perinatal- appears 2-4 weeks after birth What causes biliary atresia? - Answer --infection after birth (cytomegalovirus or rotavirus) -autoimmune disorder -developmental issue in womb -exposure to toxic substances What are symptoms of biliary atresia? - Answer -jaundice dark urine light to white stools poor wt gain and growth How do you diagnose biliary atresia? - Answer -any infant with jaundice present 2-3 weeks after birth -direct and indirect serum bilirubin -LFTs -abdominal x-ray-abdominal US -liver bx