What is a critical sign of kernicterus that a nurse should be aware of?

Kernicterus is a serious condition resulting from severe hyperbilirubinemia, where bilirubin crosses the blood-brain barrier and causes damage to the brain. One of the critical signs of kernicterus that nurses should be aware of is the absence of the Moro reflex. The Moro reflex, also known as the startle reflex, is an important indicator of neurological function in neonates. Its absence may suggest central nervous system involvement or damage, which is consistent with the neurological impairments seen in kernicterus.

The other options, though relevant to neonatal care, do not specifically indicate kernicterus. Persistent jaundice is a common finding but not uniquely indicative of kernicterus. Decreased feeding could stem from various issues unrelated to neurological impairment. Abnormal heart rate can indicate numerous conditions, making it too nonspecific in this context. Recognizing the absence of the Moro reflex allows the nurse to quickly assess for potential neurological damage associated with kernicterus, emphasizing the importance of this finding in the clinical evaluation of at-risk neonates.