Neonatal Jaundice: Pathophysiology, Assessment, and Family-Centered Care

Running header: hyperbilirubinemia 1
Neonatal Jaundice
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Neonatal Jaundice 2
Introduction
This essay will, one, describe a case study of a neonate with jaundice using the ISBAR
guidelines. That is the identification, situation, background, assessment and recommendation.
Two, critically analyze the pathophysiology of neonatal jaundice. It will critically evaluate the
clinical research on the neonate so as to discuss the pathophysiology of the clinical problem that
is being presented by the neonatal jaundice case study. Three, the assessment data that was
obtained from the case study will be accurately interpreted. Four, the role of the nurse in
creating/establishing a family centered care approached when caring for a neonate will be
discussed. Five, the family-centered care will be applied to the family of the neonate with
jaundice. Six, throughout the essay, the discussions will be evidence-based. Lastly, there will be
a conclusion that will summarize the whole essay.
Baby Jennifer Case Study.
Identification
A female neonate born at 33+3/40 gestation via spontaneous vertex delivery (SVD). It was as a
result of premature rupture of membranes. She sustained facial bruises during her birth as a result
of her presentation. Her mother Sian is a 41 multiparous woman, gravida 5, para 5+0.
Situation
Currently, she is admitted to the Special Care Nursery (SCN) where she is receiving care.
initially, it was as a result of mild respiratory distress. This was managed through supporting the
respiratory system by mechanical ventilation. She can now breathe normally. Currently, at two
days old, she was diagnosed to be having jaundice.

Neonatal Jaundice 3
Background
She was born prematurely which could be the cause of jaundice.
Assessment
Her heart rate is 130 beats per minute, respiratory rate of 40 breaths per minute, saturation of
oxygen of 95% at the room air, temperatures of 36.6’C and total serum bilirubin of
220micromols/l.
Recommendation.
For phototherapy and further monitoring (Okwundu, Okoromah, & Shah, 2012).
Pathophysiology
Physiology
Bilirubin is a product of erythrocytes breakdown and to be specific the heme
degeneration. At this state, it is insoluble in water. To be excreted in bile it has to be water
soluble. It, therefore, binds with the albumin and is conjugated by enzyme uridine
diphosphogluconurate (UDP) in the liver (Mesic, Milas, Medimurec, & Rimar, 2014). When
there is increased levels of bilirubin, the first clinical manifestation is jaundice. Yellow
coloration of the skin (Mishra, Agarwal, Deorari, & Paul, 2008).
Physiological hyperbilirubinemia.
The neonatal hyperbilirubinemia can be as a result of; one, an increased production of
bilirubin. The fetal erythrocytes turnover is higher than that of the infants/children/adults. Per
kilogram, a newborn produces twice the amount of bilirubin that the adult produces (Jolley &
Shields, 2009). Two, the high levels of bilirubin can be as a result of a decrease in its clearance.