Maternity Nursing Q 126
Which of the following when present in the urine may cause a reddish stain on the diaper of a newborn?
A. Mucus
B. Uric acid crystals
C. Bilirubin
D. Excess iron
Correct Answer: B. Uric acid crystals
Uric acid crystals in the urine may produce the reddish “brick dust” stain on the diaper. Urate crystals are made up of uric acid, an end product of normal metabolism. Babies are born with a high blood uric acid level because of the amount they get across the placenta, and this is quickly excreted in the urine and stool. If a baby is not making much urine at this time, these urate crystals will be especially concentrated and easy to see. This does not mean, however, that your baby is dehydrated. Instead, you can make sure your baby is properly drinking and urinating enough with a few simple questions.
Option A: Mucus in urine may be positive in other clinical conditions such as urinary tract infection and stones. Secreted from the vesicle glands of the genitourinary tract, mucus is not generally seen in the urine samples of children under the age of 12.
Option C: Bilirubin is a brownish-yellow substance that is produced after red blood cells break down. The body gets rid of bilirubin through the stool and urine.
Option D: Neonates and young children with certain liver disorders characteristically have a very high serum ferritin level. These conditions are gestational alloimmune liver disease (GALD) and hemophagocytic lymphohistiocytosis (HLH). It is not clear what the iron content of the ferritin is in these neonates. Knowing this will be a step toward understanding whether the pathogenesis of these conditions involves iron overload. Additionally, if urine ferritin and iron levels correlate with serum ferritin and iron levels, urine may be used as a non-invasive way to monitor iron status.