Counseling Station – G6PD

1. Introduce yourself

2. Build rapport
Ex : Mr. Lee, I would like to congrats you for having a baby boy, and he currently looked pretty
well. However, the cord blood test result had returned and there is certain issue that I need to lt
you know, your son has a condition (use condition instead of disease) named G6PD.

3. Assess the patient educational level

Ex : Before I proceed further , may I know what is your occupation?

4. Explain the condition.

Ex: For G6PD deficiency condition, your son is lacking of this G6PD enzyme, hence he is more
prone to get haemolysis d/t triggers. Haemolysis mean the RBC in your body will break down in
a large quantity.

5. “How would I know if that thing happen? And what should I do?”
Ex: Certain things that you need to take note of such as the baby will look pale(pallor), having
dark urine, maybe some yellow discolouration (jaundice) too.
S+S = TIRED EASILY, PALE

- Jaundice : Extravascular Haemolysis

- G6PD deficiency : Intravascular Haemolysis > Haemoglobinuria (dark urine)
- However, in newborns : severe jaundice ( occur very suddenly, earlier / later than
physiological Jaundice).

6. “What normally will cause the baby to have this condition?”

TRIGGER = antimalarial drug, moth ball, fava bean (kacang parang), infection, NSAID, Sulfa drugs
(Sulfonamide), antibiotics. (* PCM can)

7. “Since your baby is more prone to have severe NNJ, we should like to keep him at the ward for
few more days to observe his jaundice.”

8. “What will happen if the severe jaundice really occurs?”

In severe cases , the bilirubin may enter the brain and cause a condition called kernicterus. This
may impair his future learning ability & development in all aspects.

9. Reassure.
However, we would try our best to prevent this from happening. G6PD deficiency is more likely
a manageable problem. Don’t worry. Otherwise, your child can live a fairly normal life if he avoid
these triggers. Later I would pass you a brochure which listed down all the triggers that he need
to avoid for his wholelife.

10. Remind parent.

- If your child conditions are getting worse, bring him to the hospital immediately and remember
to inform the doctor that your child is having G6PD deficiency. As this will avoid doctor to
Counseling Station – G6PD

prescribe him the antibiotics that will worsen his condition.

- Breastfeed, mum needs to avoid the triggers too.
- Go to Dr if sick, need to tell them he has G6PD deficiency and bring the list along.
- If patient ask about genetic, then ans, girls are mostly asymptomatic as it usually passed down
to boys. However, the asymptomatic girls may passed down to her son in future.

11. Ressess the patient understanding.

- Before I end this session, do you have any questions wants to ask me?

12. Thank to the patient.

- X linked.
- 1 of the enzymes that help body process carbohydrate and turn them into energy.
- Protects RBC from the harmful byproducts that can accumulate when a person take
certain medication/ fight infection.
- Kernicterus due to deposition in the basal ganglia, hippocampus, globus pallidus.
- Can’