Practice Quiz

CNM Certified Nurse Midwife

Category - Newborn

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A nurse midwife observes that a full-term newborn has yellowish skin and sclera of the eyes on the second day of life. Total serum bilirubin level is determined at 15 mg/dL. Which of the following interventions are appropriate for the newborn?

I.Early feeding
II.Exchange transfusion
III.Phototherapy
IV.Supplemental feedings with additional formula
  1. I and III
  2. I, III and IV
  3. III and IV
  4. All of the interventions are appropriate.
Explanation
Answer: B - A newborn with physiological jaundice should be initiated with early feeding, placed under the phototherapy lights and offered supplemental feedings with additional formula. These interventions aim to reduce the levels of indirect bilirubin levels. Bowel elimination removes bilirubin as bilirubin is incorporated into feces. Early feeding stimulates bowel peristalsis. Phototherapy changes the bilirubin into a compound that can be broken down and excreted through urine and feces. Supplemental feedings may be given to newborns on phototherapy to prevent dehydration. Exchange transfusion is administered to newborns with jaundice caused by ABO or Rh incompatibility.
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