Which factor should alert the nurse to assess for the risk of jaundice?

• A. Trauma at birth
• B. Breastfeeding
• C. Premature birth
• D. Family history of jaundice

Answer: (A)

Neonatal jaundice arises when bilirubin load is high or its clearance is limited. Birth trauma can cause bruising and cephalohematoma, leading to increased red blood cell breakdown and more bilirubin entering the bloodstream. With the newborn’s liver still maturing, its ability to conjugate bilirubin is often limited, so this extra bilirubin can quickly accumulate and appear as jaundice. Because of this direct link between birth trauma and bilirubin production, the presence of trauma at birth should alert the nurse to assess for jaundice promptly, including checking for yellowing of the skin and eyes and monitoring feeding and stool/urine patterns, with bilirubin levels measured if indicated. Prematurity and breastfeeding are also risk factors, but birth trauma provides a clear etiologic signal for jaundice risk.