Hyperbilirubinemia: Symptoms, Treatment, Phototherapy, Nursing Care- Maternity Nursing | @LevelUpRN

Important nursing care includes identifying the onset of jaundice (before or after 24 hours). Parental teaching emphasizes frequent feeding to promote bilirubin excretion, which results in loose, frequent green stools. Exposure to UV light from sunlight can also help break down bilirubin.

Hyperbilirubinemia means higher than expected levels of bilirubin in the blood, typically resulting in jaundice. Bilirubin is formed from the breakdown of red blood cells. There are two main types of jaundice in newborns: physiologic and pathologic.

Physiologic jaundice is common, mild, and transient, occurring due to the infant's immature liver. It usually begins on day two to four of life, peaks between four to five days, and resolves within two weeks. It never occurs within the first day of life. Pathologic jaundice is always abnormal and occurs within the first day of life, caused by hemolysis due to maternal-fetal blood type incompatibility, leading to a rapid rise in bilirubin levels.

The main symptom of hyperbilirubinemia is jaundice, visible in the skin, eyes, and mucous membranes. Jaundice levels are measured using a light meter placed on the baby's skin, and a calculator determines the risk level based on the reading and the baby's age.

A bilirubin level greater than five milligrams per deciliter is indicative. Treatment includes phototherapy, increased frequency of breastfeeding, and potentially a blood exchange transfusion for pathologic jaundice. The major complication is kernicterus, a type of brain damage from unconjugated bilirubin crossing the blood-brain barrier, leading to permanent neurological dysfunction like cerebral palsy, seizures, and hearing loss.

Phototherapy involves placing the baby under UV lights or using bili blankets to break down bilirubin. The baby should wear only a diaper to maximize skin exposure and have their eyes protected with a special mask. Nursing considerations include turning the baby every two hours to prevent pressure injuries, monitoring temperature to prevent overheating, and checking for dehydration through urine output, weight, and mucous membranes. Lotions or moisturizers should not be applied to the baby's skin during phototherapy to prevent burns. Bilirubin levels should be rechecked every 6 to 12 hours. Parents are encouraged to hold the baby during bili blanket use, ensuring basic physiological needs are met.