A preterm newborn is more likely to develop hyperbilirubinemia ...

[dalyningkenk]

A preterm newborn is more likely to develop hyperbilirubinemia than a term newborn because the former has:
 
  a. Impaired ability to manufacture immunoglobulins
  b. Poor hepatic clearance of bilirubin and excess free fatty acids
  c. Decreased liver glycogen stores
  d. Immature kidneys, reducing excretion of bilirubin

Question 2

A preterm newborn is admitted to the neonatal intensive care unit. The parents arrive for their first visit after the birth. They approach the warmer but remain several feet away. The nurse's most appropriate action would be to:
 
  a. Wait quietly at the newborn's bedside until the parents come closer.
  b. Go to the parents, introduce herself, and gently encourage them to come meet their infant; explain equipment first, then focus on the baby.
  c. Tell the parents only about the baby's physical condition and warn them not to touch the baby.
  d. Leave the parents at the bedside while they are visiting, so they can have some privacy.

[dawsa925]

Answer to Question 1

ANS: B
Poor hepatic clearance of bilirubin and reduced fluid intake (small feedings) can inhibit the removal of bilirubin in the intestines (not kidneys). Excess free fatty acids, released through cold stress, compete with bilirubin for protein-binding sites, which displace bilirubin into circulation.

Answer to Question 2

ANS: B
Family members should be encouraged to begin the process of attachment to their newborn, which will take understanding on the part of the nurse. The nurse must offer continued assistance and support to the family and must prepare them for the newborn's limited ability to respond because of all of the medical equipment used in the newborn's care. The nurse should provide explanations to the family concerning the baby's physical development and the medical equipment in use and should remain close to the family on their initial visit.

[dalyningkenk]

Excellent

[dawsa925]

TYSM