Neonatal Hyperbilirubinemia (Jaundice)

Introduction to Neonatal Hyperbilirubinemia (Jaundice)

Neonatal Hyperbilirubinemia, commonly known as Jaundice, is a condition of elevated hyperbilirubinemia that occurs in the newborn period. It can affect normal term babies as well as preterm babies. It is characterized by yellowing of the skin and eyes due to the elevation of bilirubin levels.

Nursing Diagnosis Definition

Nursing diagnosis for Neonatal Hyperbilirubinemia (Jaundice) is defined as impaired detoxification related to changes in metabolism of bilirubin.

Defining Characteristics

Subjective

• Difficulty in gaining weight
• Decreased level of consciousness
• Weakness
• Increased icterus
• Increased abdominal girth
• Fever

Objectives

• Yellowish discoloration of skin and sclera
• Dark urine
• Pale stool color
• Retching
• Lethargy
• Irritability
• Convulsions
• Hyperactive reflexes

Related Factors

Hemolysis and other factors like Blood incompatibility, G6PD deficiency and Breastmilk Jaundice.

Risk Population

Premature babies and full-term babies with slit umbilical artery, low weight and have certain medical conditions such as G6PD deficiency.

Associated Problems

Kernicterus, feeding intolerance, anemia and extension of hospital stay.

Suggestions of Use

Initiate early monitoring of bilirubin levels, identify predisposing factors and provides adequate management or treatment to decrease the risk burden.

Suggested Alternative Nursing Diagnoses

• Impaired nutrition: Less than body Requirements
• Delayed Development
• Activity Intolerance
• Infection
• Ineffective Peripheral Tissue Perfusion

Usage Tips:

• Assess the neonate's skin and mucous membranes for jaundice.
• Monitor the blood/urine bilirubin levels.
• Refer to neonatologist/pediatrician if necessary.
• Give phototherapy as prescribed.
• Provide adequate hydration.
• Monitor feeding patterns.
• Assess for the presence of hyperactive reflexes.

NOC Results

• Biological Performance: Bilirubin levels
• Body Temperature: Core Temperature
• Nutrition: Food/Fluid Intake
• Respiratory Status: Gas Exchange
• Tissue Integrity: Skin Integrity

NIC Interventions

• Phototherapy: Illumination using fluorescent light to reduce the bilirubin levels
• Exchange transfusion: Transfusion of old blood with fresh blood components to reduce the levels of bilirubin in circulation
• Prevention of infection: Monitor immunization status, provide education about hygiene and preventive measures to avoid infections
• Hydration Therapy: Administer oral, intravenous fluids and electrolytes to decrease dehydration

Conclusion

Neonatal Hyperbilirubinemia (Jaundice) is a condition of elevated hyperbilirubinemia in newborn period. It can lead to Kernicterus, CVS and chronic hematological problems. Especially in premature babies, this requires meticulous monitoring of bilirubin levels. An early identification and appropriate management will help decreases the health risks associated with this condition.

FAQ

• What is Neonatal Hyperbilirubinemia (Jaundice)?
• What are the risk factors associated with Neonatal Hyperbilirubinemia?
• What interventions can be done to manage Neonatal Hyperbilirubinemia?