NEONATAL INTENSIVE CARE UNIT (NICU) CASE STUDY NUMBER 2: Hyperbilirubinemia CLIENT PROFILE: Patient was a 1-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. 3/7/18 3/9/18 3/10/18 3/12/18 3/6/18 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 born 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?

Phlebotomy Essentials

6th Edition

ISBN:9781451194524

Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)

Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)

Chapter1: Phlebotomy: Past And Present And The Healthcare Setting

Section: Chapter Questions

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NYS WARD Questions: 1. What would be your nursing diagnosis with this kind of laboratory results? 2. What would happen if there is incompatibility of blood between the mother and infant?

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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