Category: Pediatric Nursing Kernicterus refers to chronic, long-term neurologic issues. Symptoms include cerebral palsy, sensorineural hearing loss and gaze abnormalities. Management of neonatal jaundice is aimed at preventing the development of kernicterus.
Category: Pediatric Nursing Acute bilirubin encephalopathy refers to the early, potentially reversible, signs and symptoms, including somnolence, poor feeding, hypertonia or hypotonia and a high-pitched cry associated with severe hyperbilirubinemia (> 20 to 25 mg/dL).
Category: Maternal Neonatal Nursing Jaundice during the newborn period is usually the result of a benign, self-limited process termed physiologic jaundice of the newborn and occurs in approximately 50% of normal newborns.
Category: Maternal Neonatal Nursing Hyperbilirubinemia and jaundice in the neonate usually result from a combination of three factors: increased production, decreased clearance and excretion, and increased enterohepatic resorption.
Category: Fundamentals Bilirubin is formed by the breakdown of heme-containing proteins, primarily hemoglobin. Unconjugated bilirubin binds to albumin and is carried to the liver, where it is conjugated by glucuronyl transferase and excreted into bile.
Category: Pediatric Nursing Individuals with Marfan syndrome should be evaluated for potential cardiac abnormalities before being allowed to participate in competitive sports. Around 50% of patients with Marfan syndrome have cardiac manifestations.
Category: Pediatric Nursing Acute rheumatic fever is a common cause of acquired heart disease in children and the result of a delayed immune reaction to a group A streptococcal infection. In the United States, it most commonly occurs in children 5 to 15 years old.
Category: Pediatric Nursing Factors that predispose children with underlying anatomic cardiac defects to bacterial endocarditis include dental procedures and other surgical procedures involving the respiratory, gastrointestinal or genitourinary tracts.
Category: Pediatric Nursing The most common cause of pulseless electrical activity in children is profound hypovolemia. As such, an intravenous fluid bolus should always be considered as a therapeutic option during the treatment of pulseless electrical activity.
Category: Pediatric Nursing Asystole is the most common rhythm found in out-of-hospital cardiac arrest in children. The key to survival from any pulseless electrical activity rhythm is the rapid identification and treatment of the underlying cause.
Category: Pediatric Nursing Ventricular tachycardia is not a common dysrhythmia in children. The majority of children with ventricular tachycardia have an underlying condition, such as myocarditis, prolonged QT syndrome and drug or toxin exposures.
Category: Pediatric Nursing Children with hemodynamically unstable atrial flutter or fibrillation should be cardioverted. The initial treatment priority in patients who are hemodynamically stable is to slow the rate of the ventricular response with medications.
Category: Pediatric Nursing Both atrial flutter and atrial fibrillation are rare in children and are usually associated with underlying heart conditions (eg, CHD, status post open-heart surgical procedures that involved the atria, myocarditis, and digoxin toxicity).
Category: Pediatric Nursing Vagal maneuvers (eg, a bag containing ice and water to the face, blowing on an occluded straw) can be attempted before adenosine administration in the child with hemodynamically stable supraventricular tachycardia.
Category: Pediatric Nursing The clinician should immediate synchronized cardioversion (0.5 to 1 J/kg) for children in supraventricular tachycardia (SVT) with signs of poor perfusion, such as altered mental status, delayed capillary refill, pallor, cyanosis or hypotension.
