Questions need to be answere. 1. What's the difference between conjugated bilirubin and direct bilirubin? 2. Whe does conjugated bilirubin need to be assessed? 3. What are the clinical manifestations that would indicate development of problem/complications.
Questions need to be answere. 1. What's the difference between conjugated bilirubin and direct bilirubin? 2. Whe does conjugated bilirubin need to be assessed? 3. What are the clinical manifestations that would indicate development of problem/complications.
Chapter13: Nerves Of Steel
Section: Chapter Questions
Problem 1.1CS
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Questions need to be answere.
1. What's the difference between conjugated bilirubin and direct bilirubin?
2. Whe does conjugated bilirubin need to be assessed?
3. What are the clinical manifestations that would indicate development of problem/complications.
Transcribed Image Text:NEONATAL INTENSIVE CARE UNIT (NICU)
CASE STUDY NUMBER 2: Hyperbilirubinemia
CLIENT PROFILE:
Patient was a l-week-old infant in the level 2 NICU born at 37 weeks. This infant was
initially born with indirect hyperbilirubinemia but now also has increasingly elevated level of
direct bilirubin (see measurements in table below). Neonatologist requested conjugated and
unconjugated bilirubin test due to increasing elevated level of direct bilirubin. Conjugated
bilirubin test is not routinely performed in our hospital laboratory and needs to be send out.
3/6/18
3/7/18 3/9/18 3/10/18 3/12/18
Ref Range
Bilirubin
total, neonatal mg/dL
1.0-10.5
9.2
8.7
10.8
10.2
8.6
Bilirubin
direct,
0.0 – 0.6
0.5
0.7
1.8
1.8
2.1
mg/dL
neonatal
Pre-Assessment:
1. What's the difference between conjugated bilirubin and direct bilirubin?
Assessment: (Information gathering through history, physical examination and testing)
2. When does conjugated bilirubin need to be assessed?
3. What are the clinical manifestations that would indicate development of additional
problems/complications?
4. As a nurse, what would be your nursing management in taking care of infants with
hyperbilirubinemia?
Diagnosis: (interpreting information to identify problems/needs)
Main findings include the following:
History
• Patient is 1-week-old.
• Born at 32 weeks.
Infant was initially borm with indirect hyperbilirubinemia but now also has increasingly
elevated level of direct bilirubin with laboratory findings of Direct bilirubin at 2.1 mg/dl.
Laboratory Result:
Bilirubin total, 1.0-10.5
mg/dL
9.2
8.7
10.8
10.2
8.6
neonatal
Bilirubin
direct,
neonatal
0.0 - 0.6
mg/dL
0.5
0.7
1.8
1.8
2.1
1. What would be your nursing diagnosis with this kind of laboratory result?
2. What would happen if there is incompatibility of blood between the mother and the
infant?
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