An infant (5 days old) has lab results revealing an elevated level of unconjugated bilirubin, due to hemolysis of RBCs. Because of this, which assessment findings would correlate with this abnormal lab result? Select all that apply

Question

A) Difficulty to arouse (lethargy)
B) Cyanosis in hands and feet
C) Click in the right hip area when adducted
D) Jaundice
E) Rigidity and tremors

Answer 1

Ans: A, D
Feedback:
Unconjugated bilirubin and iron cause yellowing of the skin, or jaundice. Hyperbilirubinemia places the neonate at risk for the development of a neurologic syndrome called kernicterus. This condition is caused by the accumulation of unconjugated bilirubin in brain cells. The manifestations of kernicterus may appear 2 to 5 days after birth in term infants or by day 7 in premature infants. Lethargy, poor feeding, and short-term behavioral changes may be evident in mildly affected infants. Severe manifestations include rigidity, tremors, ataxia, and hearing loss. Extreme cases cause seizures and death. Cyanosis relates to low oxygen levels in the blood (hypoxia) and a click in a hip usually is associated with a fracture.