Editing Maternal and Newborn Nursing (section)

=== Jaundice ===

'''Physiologic jaundice''' appears '''after 24 hours''' of age, peaks around days 3 to 5, and resolves without treatment. It results from a high red cell mass with a short red cell lifespan and an immature hepatic conjugating system. '''Pathologic jaundice''' appears '''within the first 24 hours''', rises rapidly, or persists, and suggests hemolysis such as Rh or ABO incompatibility, infection, or metabolic disease. Unconjugated bilirubin is fat soluble and can cross the blood-brain barrier, causing '''acute bilirubin encephalopathy and kernicterus''', which is permanent.

Nursing care: plot bilirubin against age in hours on a risk nomogram, '''promote frequent feeding''' (8 to 12 times in 24 hours) because bilirubin is excreted in stool and delayed passage increases enterohepatic reabsorption, and for '''phototherapy''' maximize skin exposure, provide eye protection, monitor temperature and hydration, and monitor for loose green stools and rash. Water supplementation does not lower bilirubin and is not given.