Teaching Project

Teaching Experience: HyperbilirubinemiaMay 2nd, 2019Evenie Frantzdia SamWest Coast UniversityHyperbilirubinemia is the elevation of the bilirubin serum levels that is related to the hemolysis of red blood cells and the reabsorption of unconjugated meaning immature bilirubin from the small intestines. This condition is a life-threatening condition that can put the neonate at risk for many complications and unsuspected effects (Mayo Clinic, 2018). To teach someone about hyperbilirubinemia, one must understand how it is presented, how it can be treated, most importantly how it can be prevented.The most common signs and symptoms of hyperbilirubinemia are jaundice, meaning the yellowing of the infant’s skin, the sclera of the eyes, also the infant will not be able to gain any weight or not ingesting any food, and the infant’s cry is high pitched (Mayo Clinic, 2018). The risk factors for this disease include premature infants (born before 37 weeks) because they are not able to process bilirubin as well as full-term infants. Another risk factor for hyperbilirubinemia is infants who has a different blood type from their mother, this is due to the infant receiving antibodies from the placenta that causes an abnormally rapid breakdown of red blood cells (Mayo Clinic, 2018). If not treated soon or left untreated infant may develop Acute Bilirubin Encephalopathy which is when the neonate develops a fever, high-pitched cry, drowsiness and hypotonia, or decreased muscle tone.There are ways of treating hyperbilirubinemia which are phototherapy and exchange transfusion (Muchowski, 2014). The normal bilirubin level in a newborn range from 12 to 20 mg/dL, which means these treatments are implemented when the levels surpass 25 mg/dL (Muchowski, 2014). Phototherapy is absorption of light through the skin that changes unconjugated bilirubin into bilirubin photoproducts that are expelled in the infant’s stool and urine. Phototherapy is the first line of treatment for hyperbilirubinemia, however exchange transfusion is used when Acute Bilirubin Encephalopathy occur, and it has a greater adverse effect that can include blood-related or cardiorespiratory complications (Muchowski, 2014).When creating a plan of care that involves different culture and socioeconomical backgrounds, developing nursing diagnoses and interventions that correlate with the disease can be an effective way to have them understand. Nursing diagnoses includes risk for injury related to side effects of phototherapy possibly evidenced by infant’s injured eyes. Also, knowledge deficit related to lack of exposure to information as evidenced by inaccurate follow-through instructions. The intervention for nursing diagnosis number 1 is protect the infant’s eyes with eye patches, turn the neonate as well as assessing the skin every 2 hours to maintain skin integrity (Mayo Clinic, 2018). For nursing diagnostics number 2, since it involves mothers of different culture and socioeconomical background we have to consider their level of understanding. The nurse should provide information about the signs and symptoms of hyperbilirubinemia in the mother’s native language, answer questions that may arise. Also, discuss the long-term effects of the disease and what may occur if left untreated, as stated above. Provide resources such as discounted facilities that offers phototherapy if insurance will not cover or the funds have been exhausted. Most importantly to educate mother that to prevent the disease and to help treated she must breast feed the infant accurately with at least 8 to 12 feedings a day; the mother must understand that her diet must be with high-caloric in order for infant to receive the high caloric-rich breast milk (Mayo Clinic, 2018).ReferencesMayo Clinic. August 30th, 2018. Infant Jaundice. Retrieved fromhttps://www.mayoclinic.org/diseases-conditions/infant-jaundice/symptoms-causes/syc20373865Muchowski K. June 1st, 2014. Evaluation and Treatment of Neonatal Hyperbilirubinemia.Retrieved from https://www.aafp.org/afp/2014/0601/p873.html

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