N9 · Newborn jaundice
Actual Maternal and newborn
Definition
Yellow skin or eyes in a newborn from high bilirubin.- Immature liver
- blood group differences
- prematurity
- Yellow skin and eyes
- sleepy
- poor feeding
📋 Scenario
A baby on day 3 looks yellow.
Subjective (S): "His skin looks yellow."
Objective (O): Yellow face and chest on day 3; sleepy; high bilirubin.
Assessment tools for this scenario: CP-MOTHER Mother & Newborn Check CP-SKIN Skin & Wound Score
Validated scales to consider: MEOWS, APGAR, Braden Scale, TIME wound chart
**CarePath diagnosis:** Newborn jaundice related to immature liver, as evidenced by yellow skin and eyes and sleepy.
**Interventions and rationale**
| Intervention | Rationale |
|---|---|
| Check bilirubin. | Bilirubin levels show how severe the jaundice is and whether treatment is needed, because skin color alone can be misleading. |
| Feed often. | Frequent feeds make the baby pass stool and urine, which removes bilirubin from the body, and also prevent dehydration. |
| Give phototherapy as ordered. | Phototherapy light changes bilirubin into a form the baby can pass out, and it is given as ordered to lower the level safely. |
| Monitor. | Ongoing monitoring shows whether levels are falling and finds any rise early, since very high bilirubin can harm the brain. |
**Expected outcomes**
- Bilirubin falls below the treatment line.
- Feeds well.
- Yellowing fades.
- No complications.
**Linking the data to the diagnosis**
The baby is on day 3 with a yellow face and chest, and a parent says, "His skin looks yellow." He is sleepy and his bilirubin is high. This fits newborn jaundice because the yellow color and raised bilirubin are present now, so it is an actual problem, and sleepiness is a sign that needs watching. The plan aims for bilirubin to fall below the treatment line, for him to feed well, for the yellowing to fade and for complications to be avoided, through testing, frequent feeds, ordered phototherapy and close monitoring.
CarePath diagnosis
Newborn jaundice related to immature liver, as evidenced by yellow skin and eyes and sleepy.
Interventions and rationale
Listed in priority order.
| Intervention | Rationale |
|---|---|
| 1. Check bilirubin. | Bilirubin levels show how severe the jaundice is and whether treatment is needed, because skin color alone can be misleading. |
| 2. Feed often. | Frequent feeds make the baby pass stool and urine, which removes bilirubin from the body, and also prevent dehydration. |
| 3. Give phototherapy as ordered. | Phototherapy light changes bilirubin into a form the baby can pass out, and it is given as ordered to lower the level safely. |
| 4. Monitor. | Ongoing monitoring shows whether levels are falling and finds any rise early, since very high bilirubin can harm the brain. |
Expected outcomes
- Bilirubin falls below the treatment line.
- Feeds well.
- Yellowing fades.
- No complications.
Linking the data to the diagnosis
The baby is on day 3 with a yellow face and chest, and a parent says, "His skin looks yellow." He is sleepy and his bilirubin is high. This fits newborn jaundice because the yellow color and raised bilirubin are present now, so it is an actual problem, and sleepiness is a sign that needs watching. The plan aims for bilirubin to fall below the treatment line, for him to feed well, for the yellowing to fade and for complications to be avoided, through testing, frequent feeds, ordered phototherapy and close monitoring.