A nurse is assessing a newborn who was born at 35 weeks of gestation and has physiologic jaundice.

Which of the following factors increases the risk of hyperbilirubinemia in this newborn?

Prematurity

Breastfeeding

Asian ethnicity

All of the above.

Answer and Explanation

The Correct Answer is D

All of the above factors increase the risk of hyperbilirubinemia in this newborn. Hyperbilirubinemia is a condition of high levels of bilirubin in the blood that can cause jaundice and brain damage.

Choice A is wrong because prematurity is a risk factor for hyperbilirubinemia, especially in babies born before 38 weeks of gestation. Premature babies have immature livers that are less able to process bilirubin and eliminate it from the body.

Choice B is wrong because breastfeeding is a risk factor for hyperbilirubinemia, particularly in some breast-fed babies who do not get enough milk or calories. Breastfeeding can also cause increased enterohepatic circulation of bilirubin, which means that bilirubin is reabsorbed from the intestines into the bloodstream instead of being excreted in the stool.

Choice C is wrong because Asian ethnicity is a risk factor for hyperbilirubinemia, as some Asian populations have higher rates of glucose-6-phosphate dehydrogenase deficiency, a genetic condition that causes red blood cells to break down more easily and release more bilirubin. Asian infants may also have lower levels of uridine diphosphate glucuronosyltransferase, an enzyme that helps convert bilirubin into a form that can be excreted by the liver.

Normal ranges for bilirubin levels vary depending on the age, weight, and health status of the newborn. Generally, bilirubin levels peak between the third and seventh day after birth and then decline gradually. The AAP recommends using a nomogram based on the infant’s age in hours and serum bilirubin level to determine the risk of severe hyperbilirubinemia and the need for treatment. Treatment options include phototherapy and exchange transfusion.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is D

Explanation

All of the above.

The nurse should take all of the following actions to prevent increased intracranial pressure (ICP) in a preterm infant who has intraventricular hemorrhage (IVH):

• Elevate the head of the bed to 30 degrees.This helps to reduce venous congestion and improve cerebral blood flow.

• Avoid suctioning unless absolutely necessary.Suctioning can cause hypoxia, bradycardia, and increased ICP.

• Administer analgesics as prescribed.Pain can increase blood pressure and ICP.

Choice A is wrong because elevating the head of the bed alone is not enough to prevent increased ICP.

Choice B is wrong because avoiding suctioning alone is not enough to prevent increased ICP.

Choice C is wrong because administering analgesics alone is not enough to prevent increased ICP.

A. Initiate phototherapy immediately B. Notify the provider to order a serum bilirubin test C. Encourage the parent to feed the newborn more frequently D. Reassure the parent that this is a normal finding

Correct Answer is B

Explanation

Transcutaneous bilirubin measurement is a useful screening tool for neonatal hyperbilirubinemia, but it has some limitations and sources of variability.Therefore, any bilirubin screening result obtained must be confirmed by a diagnostic method before treatment.

Choice A is wrong because initiating phototherapy without confirming the bilirubin level could expose the newborn to unnecessary treatment and potential adverse effects.

Choice C is wrong because increasing hydration by feeding more frequently may not be sufficient to lower the bilirubin level if it is too high or if there are other causes of jaundice.

Choice D is wrong because reassuring the parent that this is a normal finding could delay the diagnosis and treatment of severe neonatal hyperbilirubinemia, which can lead to serious complications such as kernicterus spectrum disorders.

Normal ranges for transcutaneous bilirubin measurement vary depending on the device used, the skin pigmentation, and the postnatal age of the newborn.However, a general guideline is that a measurement of 16 mg/dL at 48 hours of age is above the 95th percentile and warrants further investigation.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A nurse is assessing a newborn who was born at 35 weeks of gestation and has physiologic jaundice. Which of the following factors increases the risk of hyperbilirubinemia in this newborn?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a preterm infant who has intraventricular hemorrhage (IVH). Which of the following actions should the nurse take to prevent increased intracranial pressure (ICP)?

Correct Answer is D

Explanation

A nurse is reviewing the transcutaneous bilirubin measurement of a newborn who is 48 hours old and has physiologic jaundice. The measurement is 16 mg/dL. Which of the following actions should the nurse take?

Correct Answer is B

Explanation

A nurse is caring for a client who has systemic lupus erythematosus (SLE). The client asks why she has to have her blood drawn so often. Which of the following responses should the nurse make?

A nurse is preparing to administer an exchange transfusion to a newborn who has severe hyperbilirubinemia due to Rh incompatibility. Which of the following actions should the nurse take first?

A nurse is assessing a newborn who was born at 35 weeks of gestation and has physiologic jaundice. Which of the following factors increases the risk of hyperbilirubinemia in this newborn?

A nurse is assessing a post-term infant who was born with intrauterine growth restriction (IUGR). Which of the following findings should the nurse expect?

A nurse is planning care for a newborn who has hyperbilirubinemia and is receiving phototherapy. Which of the following interventions should the nurse include in the plan?

A nurse is reviewing the laboratory results of a newborn who has hypoglycemia. The nurse should identify that a normal blood glucose level for a healthy term newborn is between which of the following ranges?

A nurse is evaluating a client who received an immunization for tetanus one week ago. The client reports pain and swelling at the injection site, low-grade fever, and body aches. Which of the following responses should the nurse make?

A nurse is caring for a client who delivered a post-term infant vaginally with shoulder dystocia. Which of the following findings should alert the nurse to possible injury in the infant?

A nurse is assessing a newborn who was born at 35 weeks of gestation and has physiologic jaundice.

Which of the following factors increases the risk of hyperbilirubinemia in this newborn?