Which physical signs could indicate a risk for hyperbilirubinemia?

Choice A reason:

Slow growth is a common symptom of thalassemia, especially in children. It is caused by the reduced production of hemoglobin and red blood cells, which leads to anemia and poor oxygen delivery to the tissues. Slow growth can also affect the development of facial bones and cause deformities.

Choice B reason:

Fatigue is another common symptom of thalassemia, also related to anemia and low oxygen levels in the body. People with thalassemia may feel tired, weak, and short of breath even after mild physical activity. Fatigue can also affect their mood, concentration, and quality of life.

Choice C reason:

Hematoma is not a typical symptom of thalassemia. Hematoma is a collection of blood under the skin or in an organ, usually caused by trauma, injury, or bleeding disorders. People with thalassemia may have a higher risk of bleeding due to low platelet counts or frequent blood transfusions, but this does not necessarily result in hematoma.

Choice D reason:

Pruritus is not a typical symptom of thalassemia. Pruritus is a sensation of itching that can affect any part of the body. It can have many causes, such as dry skin, allergies, infections, or liver problems. People with thalassemia may experience pruritus as a side effect of iron overload or iron chelation therapy, but it is not a direct consequence of the condition.

Choice E reason:

Ecchymoses are not typical symptoms of thalassemia. Ecchymoses are large bruises that appear on the skin due to bleeding under the surface. They can be caused by trauma, injury, or bleeding disorders. People with thalassemia may have a higher risk of bleeding due to low platelet counts or frequent blood transfusions, but this does not necessarily result in ecchymoses.

Choice A reason:

Allowing opportunities for newborn massage is not recommended for preterm newborns, as it can increase their oxygen consumption and energy expenditure. Massage can also cause stress responses, such as increased heart rate, blood pressure, and cortisol levels.

Choice B reason:

Clustering the newborn's care activities is the best way to help the newborn conserve energy, as it minimizes the frequency of handling and stimulation. Clustering care also allows for longer periods of uninterrupted sleep, which is essential for growth and development.

Choice C reason:

Changing the newborn's position every 2 hours is not necessary for preterm newborns, as it can disrupt their sleep and cause them to lose heat. Preterm newborns have limited ability to regulate their body temperature, and frequent position changes can expose them to cold stress.

Choice D reason:

Placing elbow restraints on the newborn is not indicated for preterm newborns, unless they have a specific condition that requires them, such as a cleft lip or palate repair. Elbow restraints can restrict the newborn's movement and cause skin irritation or injury.