ATI Learning Template - Hyperbilirubinemia

ACTIVE LEARNING TEMPLATE: System Disorder Anika and Chelsea STUDENT NAME______________________________________ Hyperbilirubinemia DISORDER/DISEASE PROCESS___________________________________________________________ REVIEW MODULE CHAPTER____________ Alterations in Health (Diagnosis) Pathophysiology Related to Client Problem Health Promotion and Disease Prevention In the term newborn, bilirubin levels increase more than 0.5 mg/dL/hr, peaks at greater than 12.9 mg/dL, or is associated with anemia and hepatosplenomegaly. ASSESSMENT Risk Factors Increased RBC production or breakdown Rh or ABO incompatibility Decreased liver function Maternal diabetes Oxytocin during labor Neonatal hyperthyroidism Prematurity Laboratory Tests Review Hgb and Hct A direct Coombs’ test SAFETY CONSIDERATIONS Expected Findings Yellowish tint to skin, sclera, and mucous membranes. Diagnostic Procedures Transcutaneous bilirubin level is a noninvasive method to measure a newborn’s bilirubin level PATIENT-CENTERED CARE Nursing Care Monitor the newborn’s bilirubin levels every 4 hr until the level returns to normal. Check electrolyte levels for dehydration from phototherapy. Therapeutic Procedures Phototherapy: The newborn’s bilirubin should start to decrease within 4 to 6 hr after starting treatment. ACTIVE LEARNING TEMPLATES Complications Medications Client Education Remember and adhere to the newborn’s plan of care. Newborns who have low to moderate risk of hyperbilirubinemia should receive follow up care within two days. Newborns at higher risk should be seen within 24 hr. Interprofessional Care Acute bilirubin encephalopath y is when the bilirubin is deposited in the brain. Kernicterus is an irreversible, chronic result of bilirubin toxicity.