A blood sample for measurement of bilirubin is required from a ...

[big1devin]

A blood sample for measurement of bilirubin is required from a newborn receiving phototherapy. In what environment should this blood sample be drawn?
 
  a. While phototherapy lights are turned off
  b. While newborn remains under phototherapy lights
  c. When newborn is covered with a blanket
  d. When newborn has been off phototherapy for 30 to 60 minutes

Question 2

Early clinical manifestations of bilirubin encephalopathy in the newborn include:
 
  a. mental retardation.
  b. absence of stooling.
  c. lethargy or irritability.
  d. increased or decreased temperature.

[elizabethrperez]

Answer to Question 1

ANS: A
When blood is drawn, phototherapy lights are turned off, and the blood is transported in a covered tube to avoid a false reading as a result of bilirubin destruction in the test tube. The lights will cause a degradation of the bilirubin in the sample, resulting in a falsely lowered result. The newborn does not need to be covered with a blanket. The phototherapy lights must be off. There is no reason to delay obtaining the blood sample. It can be drawn as soon as the lights are turned off.

Answer to Question 2

ANS: C
Clinical manifestations of bilirubin encephalopathy are those of nervous system depression or excitation. Prodromal symptoms consist of decreased activity, lethargy, irritability, hypotonia, and seizures. Newborns who survive may have evidence of mental retardation. Absence of stooling and increased/decreased temperature are not manifestations of bilirubin encephalopathy.

[big1devin]

Gracias!

[upturnedfurball]

TYSM