Question

A 4-day-old baby born via cesarean section is slightly jaundiced. The laboratory reports a bilirubin assessment of 6.0 mg/dL. Which of the following would the nurse

expect the neonatalogist to order for the baby at this time?
1. To be placed under phototherapy.
2. To be discharged home with the parents.
3. To be prepared for a replacement transfusion.
4. To be fed glucose water between routine feeds.

Answer 1

The neonatologist is likely to order the slightly jaundiced 4-day-old baby to be placed under phototherapy to reduce the bilirubin level, as it is a safe and common treatment for newborn jaundice.

Step-by-step explanation:

A 4-day-old baby born via cesarean section is slightly jaundiced with a laboratory reported bilirubin level of 6.0 mg/dL. Given the understanding that neonatal jaundice is often treated with phototherapy to lower the levels of circulating bilirubin, the neonatologist is likely to order the baby to be placed under phototherapy. This is because the liver in newborns may not be fully developed, leading to a build-up of unconjugated bilirubin. When the level of bilirubin becomes too high, it can penetrate the blood-brain barrier, which is not yet fully functional in newborns, causing a condition known as kernicterus that can result in brain damage. However, a bilirubin level of 6.0 mg/dL does not indicate a need for extreme measures such as replacement transfusion, which is considered when levels exceed 25 mg/100 ml and are associated with severe hyperbilirubinemia. On the contrary, breast milk or formula should be continued to ensure hydration and aid in the passage of meconium, helping to clear the bilirubin.