Hyperbilirubinemia Research Paper

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Hyperbilirubinemia is a condition that occurs from having too much bilirubin in the blood. Bilirubin is formed when red blood cells are broken down into protein and heme fragments. Heme is composed of unconjugated bilirubin, which binds with albumin and is transported to the liver where it combines with glucuronide to form conjugated bilirubin. Typically, the conjugated bilirubin would be excreted in the urine or feces once it is metabolized as urobilinogen. If the body is unable to rid itself of the bilirubin, it causes a yellowing of the skin, eyes, and other tissues which is known as jaundice.
In infants, there are multiple causes of hyperbilirubinemia. Physiologic jaundice is a term used to describe the first few days of life when the …show more content…

The light source from phototherapy works by transforming bilirubin into water-soluble particles that can be eliminated in the urine ("Fundamentals of Phototherapy," 2007). If a neonate has risk factors such as gestational age under 38 weeks, previous jaundiced sibling, mother exclusively breastfeeding, or visible jaundice in the first 24 hours of life, further workup will be completed ("Hyperbilirubinemia (neonatal)," 2016). The effectiveness of phototherapy depends on the intensity of the light source used, time under the light, and the surface area of the neonate’s body exposed. Phototherapy is typically administered constantly, except for feedings and specific medical care or lab draws. Common policies for phototherapy include placing the infant in a radiant warmer set to a specific temperature, protective eye shields, measurement and documentation for changes in lights, and turning off the light prior to bilirubin lab draws. Duties as a nurse should include verifying provider’s orders, education on phototherapy to the family, light checks, labs, and patient temperature (American Academy of Pediatrics, 2012). Most hospitals have clinical pathways and guidelines that aid in timely interventions and prevention of further complications from hyperbilirubinemia. Some hospitals may have nurse-initiated neonatal jaundice management

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