Nursing Diagnoses for Kernicterus

[jennymaths]

Hi,

Could somebody please help me with nursing diagnoses related to kernicterus, as well as nursing implications for the disease? What should a nurse be looking for when she hears her patient has a history of kernicterus? I have to do a presentation on this. That's why I was searching. Thank you...

[elprup, BSN, RN]

IF I had to do this I would check out A Care PLan Book from the library or buy from barns and knobles. There are tons and give you just what you need. Buy the one you like and you'll be good to go for anything that is thrown your way.

regards

[SteveNNP, MSN, NP]

Kernicterus is when bilirubin levels have gotten so high, the brain becomes stained yellow, and pts show signs of altered neurological fxn. A neuro nursing dx would be appropriate.

[Daytonite, BSN, RN]

before any diagnosing can be done on any patient, an assessment has to be done. for nurses, particularly nursing students, this involves:

• a physical assessment of the patient
  
• assessment of the patient's ability and any assistance they need to accomplish their adls (activities of daily living) with the disease
  
• data collected from the medical record (information in the doctor's history and physical, information in the doctor's progress notes, test result information, notes by ancillary healthcare providers such as physical therapists and dietitians
  
• knowing the pathophysiology, signs/symptoms, usual tests ordered, and medical treatment for the medical disease or condition that the patient has. this includes knowing about any medical procedures that have been performed on the patient, their expected consequences during the healing phase, and potential complications. if this information is not known, then you need to research and find it.

kernicterus occurs in newborns during day 2 to 8 of life due to elevated bilirubin levels

• http://www.emedicine.com/ped/topic1247.htm - kernicterus - includes some of the pathophysiology
  
• http://www.medscape.com/viewarticle/406347 - neonatal hyperbilirubinaemia: early detection and appropriate treatment prevent kernicterus

nursing diagnosing is based on the patient's responses to their disease process. for convenience, we call those responses a number of things (abnormal data, defining characteristics, signs and symptoms, evidence). whatever you want to call them, you cannot pick out any nursing diagnoses without them.

patients with kernicterus will have:

• acute phase
  • decreased alertness
    
  • hypotonia
    
  • poor feeding
    
  • retrocollis (backward arching of the neck)
    
  • opisthotonus (backward arching of the back)
    
  • eventually, hypotonia

  [*]chronic phase

  • hypotonia
    
  • hyperreflexia
    
  • delayed acquisition of motor milestones
    
  • athetosis
    
  • chorea
    
  • visual gaze palsies
    
  • high-frequency hearing loss
    
  • some degree of dental enamel hypoplasia

from that information you should be able to come up with a whole handful of nursing diagnoses. however, i strongly suggest that you read the two articles i listed above as well as any other information you can find in the library about this disease. you might try searching for information about it on these weblinks:

• https://allnurses.com/forums/f205/medical-disease-information-treatment-procedures-test-reference-websites-258109.html - medical disease information/treatment/procedures/test reference websites