The nurse is planning an educational presentation on hyperbilirubinemia for nursery nurses. Which statement is most important to include in the presentation?
1. Conjugated bilirubin is eliminated in the conjugated state.
2. Unconjugated bilirubin is neurotoxic, and cannot cross the placenta.
3. Total bilirubin is the sum of the direct and indirect levels.
4. Antibiotics decrease the incidence of hyperbilirubinemia.
3
Rationale:
1. Conjugated bilirubin can be transformed back into unconjugated bilirubin prior to excretion by ?-glucuronidase enzyme if gut bacteria have not transformed it into urobilinogen.
2. Unconjugated bilirubin is neurotoxic, but crosses the placenta during fetal life for the maternal GI system to conjugate and excrete.
3. This is true. Conjugated bilirubin is also referred to as direct, while unconjugated bilirubin is also referred to as indirect.
4. Because of the role of gut bacteria in converting conjugated bilirubin into urobilinogen, neonates who have been administered antibiotics have an increased incidence of hyperbilirubinemia.
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