Elevation of serum bilirubin levels is related to hemolysis of RBCs and subsequent re-absorption of unconjugated
bilirubin from the small intestines. The condition may be benign or may place the neonate at risk for multiple
NEONATAL ASSESSMENT DATA BASE
May be pale, indicating anemia
Residing at altitudes above 5000 ft
Cardiomegaly; increased bleeding tendencies (hydrops fetalis)
Bowel sounds hypoactive.
Meconium passage may be delayed.
Stools may be loose/greenish brown during bilirubin excretion.
Urine dark, concentrated; brownish black (bronze baby syndrome).
History of delayed/poor oral feeding, poor sucking reflex.
More likely to be breastfed than bottle-fed.
Abdominal palpation may reveal enlarged spleen, liver.
Generalized edema, ascites (hydrops fetalis).
Large cephalhematoma may be noted over one or both parietal bones related to birth trauma/vacuum extraction
Loss of Moro reflex may be noted.
Opisthotonos with rigid arching of back, bulging fontanels, shrill cry, seizure activity (crisis stage).
History of asphyxia
Crackles, pink-tinged mucus (pleural edema, pulmonary hemorrhages)
History may be positive for infection/neonatal sepsis.
May have excessive ecchymosis, petechiae, intracranial bleeding.
May appear jaundiced initially on the face with progression to distal parts of the body; skin brownish black in color
(bronze baby syndrome) as a side effect of phototherapy.
May be preterm, SGA infant, infant with IUGR, or LGA infant, such as IDM.
Birth trauma may have occurred associated with cold stress, asphyxia, hypoxia, acidosis, hypoglycemia,
Occurs more often in male than female infants.
May have congenital hypothyroidism, biliary atresia, cystic fibrosis (inspissated bile)
Family factors; e.g., ethnic descent (Asian, Greek, or Korean), history of hyperbilirubinemia in previous