On her second postpartum day, the mother of a newborn says, “The doctor says the baby has physiologic jaundice.
Even though it is supposed to be normal, I don’t understand why it occurs.” Which fact regarding physiologic jaundice should form the basis of the nurse’s response?
It is caused by an increase in neonatal metabolism.
It is related to the destruction of fetal red blood cells.
It is caused by an antigen-antibody reaction.
It is related to the immaturity of the reticuloendothelial system.
The Correct Answer is B
Physiologic jaundice is a common condition in newborns that occurs when the baby’s blood contains an excess of bilirubin, a yellow pigment produced during the normal breakdown of red blood cells.In the womb, the mother’s liver removes bilirubin for the baby, but after birth the baby’s own liver must take over this function.Because the baby has more red blood cells than an adult and their liver is still immature, they may not be able to process all the bilirubin and it may build up in their skin and eyes, causing a yellowish appearance.
Choice A is wrong because it is not an increase in neonatal metabolism that causes physiologic jaundice, but rather a decrease in hepatic metabolism of bilirubin.
Choice C is wrong because it describes a different type of jaundice called hemolytic jaundice, which occurs when there is an incompatibility between the blood types of the mother and the baby, leading to an immune reaction that destroys the baby’s red blood cells faster than they can be replaced.
Choice D is wrong because it confuses the reticuloendothelial system with the hepatic system.
The reticuloendothelial system is a network of cells and tissues that are involved in immune responses and phagocytosis (the ingestion of foreign particles or cells).
The hepatic system is the system of organs and structures that are involved in liver functions, such as bile production and detoxification.
Normal ranges for bilirubin levels in newborns are 1 to 12 mg/dL (17 to 205 micromol/L) for total bilirubin and 0.2 to 1.4 mg/dL (3 to 24 micromol/L) for direct bilirubin.
Physiologic jaundice usually peaks at 3 to 5 days after birth and resolves by 2 weeks of age.
It does not require treatment unless the bilirubin levels are very high or rising rapidly, which may indicate a more serious condition or a risk of brain damage.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
The correct answer is choice B. The patient’s uterine contraction pattern is enhanced.Prostaglandin E2 gel is used to induce labor by ripening and dilating the cervix and stimulating uterine contractions.The effectiveness of the gel can be measured by the frequency, duration and intensity of the contractions.
A stronger and more regular contraction pattern indicates that the gel is working and labor is progressing.
Choice A is wrong because cervical dilation is not the only indicator of labor induction.Cervical dilation can occur without contractions or with weak and irregular contractions, which means that labor is not established yet.
Choice C is wrong because cervical softening (or effacement) is a prerequisite for cervical dilation, but it does not necessarily mean that labor has started.Cervical softening can occur weeks before labor or even during pregnancy.
Choice D is wrong because uterine softening (or relaxation) is the opposite of what prostaglandin E2 gel is supposed to do.Uterine softening reduces the contractility and tone of the uterus, which can lead to prolonged labor or fetal distress.
Correct Answer is A
Explanation
The correct answer is choice A. The patient uses the sitz bath three times a day.This indicates that the patient understands the benefits of sitz baths for postpartum recovery, such as pain relief, increased blood flow, relaxation, cleansing, and itch relief.Sitz baths can be done with warm or cool water, depending on the preference of the patient.However, they should not be done for more than 20 minutes at a time, as this can cause the stitches in the perineal area to fall apart.
Therefore, choice C is wrong.Choice B is also wrong, as there is no evidence that alternating between warm and cool sitz baths has any additional benefits or effects.
Choice D is wrong, as tightening and relaxing the perineal muscles during a sitz bath is not recommended.This can cause more pain and irritation to the area, and interfere with the healing process.The normal ranges for sitz baths are two to four times a day for up to 20 minutes each.
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