Scribd
Upload
148 views

PHOTOTHERAPY

Phototherapy uses visible light to treat hyperbilirubinemia or jaundice in newborns by transforming bilirubin into forms that can be eliminated from the body without liver processing. Proper nursing care during phototherapy includes eye protection, maximizing skin exposure to light, frequent repositioning of infants, and addressing hydration and skin health needs to improve treatment effectiveness and outcomes.

Uploaded by

kimglaidyl bontuyan
Copyright
© © All Rights Reserved
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
148 views

PHOTOTHERAPY

Phototherapy uses visible light to treat hyperbilirubinemia or jaundice in newborns by transforming bilirubin into forms that can be eliminated from the body without liver processing. Proper nursing care during phototherapy includes eye protection, maximizing skin exposure to light, frequent repositioning of infants, and addressing hydration and skin health needs to improve treatment effectiveness and outcomes.

Uploaded by

kimglaidyl bontuyan
Copyright
© © All Rights Reserved
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
You are on page 1/ 3

I.

INTRODUCTION

Phototherapy is the use of visible light for the treatment of hyperbilirubinemia in the newborn.
Neonatal jaundice (hyperbilirubinemia) is the yellow coloration of the skin and sclera in newborns, with
jaundice the result of accumulation of unconjugated bilirubin. Approximately 60% of newborns become
clinically jaundiced. Proper nursing care enhances the effectiveness of phototherapy and minimizes
complications.

II. NORMAL BILIRUBIN METABOLISM

 Humans continuously form bilirubin, and newborn infants produce relatively more bilirubin than
any other age group.

 The typical bilirubin load of the newborn is quite high, 2 to 3 times that of an adult.

 Bilirubin is a product of the normal destruction of circulating erythrocytes (which have a


shortened lifespan in the newborn infant) and increased turnover of cytochromes.

 For neonates born at ≥ 35 wk gestation, phototherapy is an option when unconjugated


bilirubin is > 12 mg/dL and may be indicated when unconjugated bilirubin is > 15 mg/dL at 25
to 48 h, 18 mg/dL at 49 to 72 h, and 20 mg/dL at> 72 h.

III. HOW PHOTOTHERAPY WORKS

Phototherapy lowers the serum bilirubin level by transforming bilirubin into water-soluble
isomers that can be eliminated without conjugation in the liver. The dose in turn is determined by the
wavelength of the light, the intensity of the light (irradiance), the distance between the light and the
baby, and the body surface area exposed to the light.

IV. PHOTOTHERAPY DEVICES

a. Overhead phototherapy devices


- these devices provide high irradiance in the blue to blue-green spectrum without excessive
heat generation. Light-emitting-diode units are efficient, long-lasting, and cost-effective.

b. Phototherapy Blankets
- contain a tungsten-halogen bulb that delivers light via a cable into a plastic pad containing
fiberoptic fibers. The pad remains cool and can be placed directly under an infant to increase the skin
surface area that is exposed. The pad can also be wrapped around the infant’s midsection to provide
phototherapy while the infant is being held. Because the spectral power of the pad alone is low, it is
commonly used in conjunction with overhead lights to provide double phototherapy.

V. NURSING CARE OF THE INFANT

a. Provide Eye Protection


Opaque eye shields must be used during phototherapy to protect the infant’s eyes from
retinal damage. To adequately block the transmission of light, carefully apply eye coverings by
first closing the infant’s eyes and then applying shields securely.

b. Assess Skin Exposure


The largest surface area of the infant’s body, the trunk, should be positioned in the
center of the light, where irradiance is highest. The American Academy of Pediatrics
recommends removing diapers for intensive phototherapy.

c. Proper Positioning
Turn infants in a prone/supine position every 2 to 3 hours to expose different areas of
skin to improve the effectiveness of phototherapy.

d. Promoting Elimination and Skin Integrity


Watery stools and diarrhea have been observed in infants undergoing phototherapy.
These characteristic dark greenish stools are related to the increased excretion of
unconjugated bilirubin from the intestines. Protective skin care is necessary to prevent perineal
skin breakdown from watery stools.

e. Hydration
Excessive fluid losses via the skin are of particular concern in the smallest, most
immature infants during the first week of life. For breastfed infants with evidence of
dehydration, supplementation with a milk-based formula inhibits the enterohepatic circulation of
bilirubin and may improve the efficacy of phototherapy.

f. Promoting Parent-Infant Interactions


Phototherapy necessarily separates the neonate from its mother and may interfere with
the process of establishing lactation. Unless jaundice is severe, phototherapy can be safely be
interrupted at feeding time to allow continuation of breastfeeding, parental visits, and skin-to-
skin care.

REFERENCES
E-book:
Stokowski, L. (2011). Fundamentals of Phototherapy for Neonatal Jaundice  [Ebook]. The National
Association of Neonatal Nurses. Retrieved from https://nursing.ce connection.com/ovidfiles/
00149525-201110001-00003.pdf

Internet Sources:
Melbourne, T. (2020). Clinical Guidelines (Nursing) : Phototherapy for neonatal jaundice. Retrieved 8
November 2020, from https://www.rch.org.au/rchcpg/hospital_clinical guideline_index
/Phototherapy_

Neonatal Hyperbilirubinemia - Pediatrics - MSD Manual Professional Edition. (2020). Retrieved 8


November 2020, from https://www.msdmanuals.com/professional/pediatrics/metabolic-electrolyte-
and-toxic-disorders-in-neonates/neonatal-hyperbilirubinemia

Phototherapy for Jaundice: Background, Indications, Contraindications. (2020). Retrieved 8


November 2020, from https://emedicine.medscape.com/article/1894477- overview#:~:text=A
%20commonly%20used%20rule%20of,10mg%2FdL%20and%2s

You might also like