neonatal%20jaundice
NEONATAL JAUNDICE
Jaundice that appears in a newborn <24 hour old is most likely nonphysiologic and needs further evaluation.
Jaundice typically presents on the 2nd-3rd day of life. It is usually first seen on the face and forehead then progresses caudally to the trunk and extremities.
Visible jaundice in the feet may be an indication to check bilirubin level.
Visual estimation of bilirubin level is often inaccurate and unreliable.
Danger signs in a newborn infant with jaundice includes changes in brainstem evoked auditory potentials, changes in muscle tone, seizures and altered cry characteristics.
The presence of any of the danger signs require prompt attention to prevent kernicterus.

Monitoring

  • All infants should be routinely monitored for jaundice by nursing staff & physicians
    • Assessment for jaundice should be done every 8-12 hour in a well-lit room, preferably in daylight by a window
    • Detection of jaundice is aided by finger pressure on the skin which reveals the underlying color of the skin & subcutaneous tissue
    • Jaundice is usually first seen on the face & forehead then progresses caudally to the trunk & extremities
    • More intense jaundice may be associated with drowsiness
    • Stool color should be monitored for all patients with jaundice; clay-colored stools may indicate cholestasis
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