Question

The nurse identifies that the newborn is jaundiced within the first 24 hours, with jaundice over bony prominences of the face and the mucous membrane. The nurse recognizes that this is:

1) physiological
2) normal
3) abnormal
4) transitory

Answer 1

Jaundice within the first 24 hours of a newborn's life is considered abnormal and may indicate serious health issues. It requires prompt medical attention and is typically treated with phototherapy to prevent complications such as brain damage.

Step-by-step explanation:

The appearance of jaundice within the first 24 hours of life in a newborn is generally considered abnormal. Jaundice is caused by the accumulation of bilirubin, a yellow pigment produced during the normal breakdown of red blood cells. Bilirubin is usually processed by the liver and safely removed from the body. However, newborns can sometimes have elevated bilirubin levels as their liver may not be fully developed or efficient enough at processing it.

In normal conditions, some degree of jaundice can occur after the first day of life and is known as physiological jaundice, progressing from the head downward and peaking around the third to the fifth day. On the other hand, jaundice that appears within the first 24 hours is often a sign of a more serious condition such as hemolysis, infection, or liver dysfunction and requires prompt medical attention. Thus, the nurse identifying jaundice within the first 24 hours and over bony prominences of the face and mucous membrane should categorize this as abnormal (option 3).

Early identification of abnormal jaundice is crucial as high levels of circulating bilirubin are neurotoxic and, without treatment, can lead to serious complications such as kernicterus, a type of brain damage. Newborns with significant jaundice are typically treated with phototherapy, which helps to break down bilirubin in the skin.