A nurse is assessing a newborn for signs of jaundice.

Which of the following methods should the nurse use to detect jaundice in the newborn?

This method allows the nurse to detect jaundice by observing the color of the skin after applying and releasing pressure.

This is a simple and noninvasive way to check for jaundice in a newborn.

Choice A is wrong because palpating the newborn’s abdomen for hepatomegaly is not a reliable way to detect jaundice.Hepatomegaly is an enlargement of the liver that may indicate liver disease, but it is not specific to jaundice.

Choice B is wrong because measuring the newborn’s serum bilirubin level is not a method to detect jaundice, but rather to confirm and quantify it.

Serum bilirubin level is the amount of bilirubin in the blood, which is responsible for the yellow color of jaundice.A blood test is required to measure this level.

Choice D is wrong because observing the newborn’s urine and stool color is not a reliable way to detect jaundice.

The color of urine and stool may vary depending on the hydration status, feeding type and other factors of the newborn.Moreover, urine and stool color may not change until the bilirubin level is very high.

Elevated direct bilirubin level: Pathologic jaundice is caused by an excessive breakdown of red blood cells due to blood incompatibility or liver disease.

This leads to an increased production of bilirubin, which is a yellow pigment that results from the breakdown of heme.

Bilirubin can be either unconjugated (indirect) or conjugated (direct), depending on whether it is bound to a protein called albumin or not.

Unconjugated bilirubin is not water-soluble and cannot be excreted in urine or bile.

It needs to be converted to conjugated bilirubin by the liver, which is water-soluble and can be eliminated from the body.However, if the liver is damaged or overwhelmed by the amount of bilirubin, some of the conjugated bilirubin can leak back into the bloodstream and cause an elevated direct bilirubin level.

• Decreased hematocrit level: Hematocrit is the percentage of red blood cells in the blood.When red blood cells are destroyed due to blood incompatibility or liver disease, the hematocrit level decreases.

This can lead to anemia, which is a condition where the blood does not carry enough oxygen to the tissues.

Positive direct Coombs test: A Coombs test is a blood test that detects antibodies that bind to red blood cells and cause them to clump together and be destroyed.

A direct Coombs test checks for antibodies that are attached to the red blood cells of the newborn.A positive direct Coombs test indicates that there is an immune reaction between the mother’s and the baby’s blood types, which can cause hemolysis (destruction of red blood cells) and jaundice.

Choice A is wrong because it only explains one aspect of pathologic jaundice, but not the other two.

Choice B is wrong because it only explains one aspect of pathologic jaundice, but not the other two.

Choice C is wrong because it only explains one aspect of pathologic jaundice, but not the other two.

Normal ranges for direct bilirubin are 0 to 0.3 mg/dL (0 to 5 mic