NEONATAL INTENSIVE CARE UNIT (NICU) CASE STUDY NUMBER 2: Hyperbilirubinemia CLIENT PROFILE: Patient was a l-week-old infant in the level 2 NICU born at 37 weeks. This infant was initially born with...

Extracted text: NEONATAL INTENSIVE CARE UNIT (NICU) CASE STUDY NUMBER 2: Hyperbilirubinemia CLIENT PROFILE: Patient was a l-week-old infant in the level 2 NICU born at 37 weeks. This infant was initially born with indirect hyperbilirubinemia but now also has increasingly elevated level of direct bilirubin (see measurements in table below). Neonatologist requested conjugated and unconjugated bilirubin test due to increasing elevated level of direct bilirubin. Conjugated bilirubin test is not routinely performed in our hospital laboratory and needs to be send out. 3/6/18 3/7/18 3/9/18 3/10/18 3/12/18 Ref Range Bilirubin 1.0-10.5 9.2 8.7 10.8 10.2 8.6 total, neonatal mg/dL Bilirubin direct, neonatal 0.0 - 0.6 mg/dL 0.5 0.7 1.8 1.8 2.1 Pre-Assessment: 1. What's the difference between conjugated bilirubin and direct bilirubin? Assessment: (Information gathering through history, physical examination and testing) 2. When does conjugated bilirubin need to be assessed? 3. What are the clinical manifestations that would indicate development of additional problems/complications? 4. As a nurse, what would be your nursing management in taking care of infants with hyperbilirubinemia? Diagnosis: (interpreting information to identify problems/needs) Main findings include the following: History Patient is 1-week-old. • Born at 32 weeks. • Infant was initially born with indirect hyperbilirubinemia but now also has increasingly elevated level of direct bilirubin with laboratory findings of Direct bilirubin at 2.1 mg/dl.