What´s Neonatal Jaundice

Newborn jaundice is a condition marked by high levels of bilirubin in the blood. The increased bilirubin causes the infant's skin and whites of the eyes (sclera) to look yellow.

Neonatal RDS is a condition of increasing respiratory distress commencing at or shortly after birth (BAPM-2006). It’s the single most important cause of morbidity and mortality in preterm infants (Greenough, et al 2004). Typically RDS affects preterm infants with the incidence being inversely proportional to the gestational age (Stewart 2005) Approximately 60% of those born before 28 weeks gestation are affected (Fraser, et al 2004) Incidence also increases in infants of diabetic mothers those born via elective caesarean section (Fraser, et al 2004) and perinatal asphyxia (Rodriguez, 2003).

There are more than 70% of premature babies that are born between 34 and 36 weeks gestation a year. When a baby is born early, or born with birth defects, the Neonatal Intensive Care unit is its first home. The nurse’s in the NICU have the difficult job of preparing baby’s and parents for a health life together. A baby who has been put into the NICU will stay there until it is healthy enough to go home.

The new versus classic BPD features have changed over the years. The approaches to care, including surfactant administration, permissive hypercapnia, and noninvasive ventilation have changed. All these has increased the survival of low birth weight infants as before with classic BPD. The classic BPD was before surfactant and more management techniques, and inflammation and alveolar septal fibrosis. All these changes were associated with oxygen toxicity, infection, and barotrauma.

Premature babies sometimes have apnea. It may happen together with a slow heart rate. Respiratory distress syndrome or RDS is a breathing problem most common in babies born before 34 weeks of pregnancy.” Babies with RDS don’t have a protein called surfactant that keeps small air sacs in the lungs from collapsing. “Intraventricular hemorrhage or IVH is bleeding in the brain. It usually happens near the ventricles in the center of the brain. A ventricles is a space in the brain that’s filled with fluid. Patent ductus ateriosus or PDA is a heart problem that happens in the connection between two major blood vessels near the heart. If the ductus do not close properly after birth, a baby can have breathing problems or heart failure. Heart failure is when enough blood can’t get pumped into the heart causing it to shut down. Necrotizing enter colitis (NEC) is a problem with a baby’s intestines. It causes feeding problems, a swollen belly and diarrhea. It sometimes happens 2 to 3 weeks after a premature bay has been born. Retinopathy of prematurity (ROP) is an abnormal growth of blood vessels in the eye. ROP can lead to vision loss. Jaundice is when a baby's eyes and skin look yellow. A baby has jaundice when his liver isn't fully developed or isn't working well. Anemia is when a baby doesn’t have enough healthy red blood cells to carry oxygen to the rest of the body. Bronchopulmonary dysplasia (BPD) is a lung condition that can develop in premature babies as well as babies who have treatment with a breathing machine. Babies with BPD sometimes develop fluid in the lungs, scarring and lung damage. Premature babies often have trouble fighting off germs because their immune systems are not fully formed. Infections that may affect a premature baby include pneumonia, a lung infection; sepsis, a blood infection; and meningitis, an infection in the fluid around the brain and

The patient population is the preterm babies that are less than 37 weeks’ and weight

Some of the progressive signs of respiratory distress exhibited by this infant after birth are; nasal flaring, grunting, coarse breath sounds, increase respiratory rate of 100 and irregular, acrocyanosis, his appearance of being pale, circumoral cyanosis, and him developing jaundice as a result of his increased work of breathing and hypoxia which causes an increase in erythropoietin to be released from the kidneys resulting in polycythemia as a result of low levels of oxygen in the body. Subsequently, as a result of an increase or red blood cell production the body will develop jaundice due to an increase in red blood cell breakdown which causes an increase of bilirubin in the blood to accumulate, therefore, causing jaundice to develop.

According to the World Health Organisation [WHO] (2014) pre-term babies are at increased risk of illness, disability and death. It also states that globally 15 million babies are born pre-term and the figures are rising. In England and Wales during 2012 7.3% of live births were pre-term under 37 weeks nearly 85% of all babies born prematurely will have a very low birth weight (Office for National Statistics, 2012). Pre-term birth is associated with respiratory complications and lung disease, long-tern neurological damage and problems with bowel function (Henderson & Macdonald, 2011). Neonatal services provide care to babies who are born prematurely or are ill and require specialist care. It is seen that sixty per cent of infant deaths occur in the neonatal period (DH,

Premature newborns have an increased risk of complications because their bodies still have underdeveloped parts such as the lungs, digestive system, immune system, and skin. Thus, promoting oxygenation, nutrition, and fluid balance, maintaining thermal regulation, resuscitation and transferring the newborn to NICU unit will help the child to get better (Ricci el., 2017, pg. 887).

This requires the administration of a heel-prick test in the nursery home or within 7 days of birth. The blood sample will be screened for all disorders (phenylketonuria, congenital hypothyroidism, sickle cell disease and cystic fibrosis, Duchenne muscular dystrophy, and Krabbe). Adopting this option would provide an opportunity for earlier detection and treatment of the disease. However, there is a chance for false-positive results as well as the added costs. There is also the ethical dilemma of patient autonomy and free-will.

Provide information about jaundice and implications of hyperbilirubinemia. Encourage to ask questions; reinforce or clarify information, as needed. Include teaching on hospital rationales for interventions.

The lack of solid markers to determine the long term outcome and prognosis in neonates with Hypoxic Ischaemic Encephalopathy makes parents counseling very challenging.

The Boston Children’s Hospital defines this as a condition where there is too much bilirubin in a baby’s blood and other tissues and fluids.

Tuberculosis is spread by inhalation or ingestion of the bacteria, either directly through infected milk, the placenta or ingesting contaminated food and water, or indirectly through environmental conditions such as being where infected badgers have been (DARDNI, 2013). Bovine TB can take months or even years to start showing signs which is why it is important to test cattle regularly. This is done with the Single Intradermal Comparative Cervical Tuberculin test (SICCT). Both the bovine and avian form of tuberculosis is injected side by side into the neck. After 72 hours, the site is re-checked for a reaction. A bovine TB infected cow will show more swelling on the bovine tuberculin site than on the avian tuberculin site, thus proving that the cow is a reactor for bovine

Immunizations: Childhood immunizations up to date. Last influenza, “probably 2 years ago”. No TB skin test.