phototherapy in the newborn

phototherapy in the newborn,

a treatment for hyperbilirubinemia and jaundice in the newborn that involves the exposure of an infant's bare skin to intense fluorescent light. The blue range of light accelerates the excretion of bilirubin in the skin, decomposing it by photooxidation.

method The infant is placed nude under the fluorescent lights with the eyes and genitalia covered. The baby is turned frequently, and the body temperature is monitored, using a skin thermistor. All vital signs are carefully noted, and details regarding position of the bulbs, time and duration of treatment, and the infant's response are charted. Adverse effects of phototherapy include dehydration: An infant may need 25% more fluid during treatment. Loose stools and "bronze baby" syndrome may occur.

interventions The nurse performs phototherapy and may be responsible for collecting specimens for serial tests for bilirubin level in the blood. The lights may scorch the nurse's hair and irritate the eyes. As protection, a cap and sunglasses may be worn. Breastfeeding may be discontinued during treatment but often is not. Additional water is always given. The family is encouraged to visit and to participate in caring for the infant. They may be told that the eye shields are necessary but do not seem to bother the infant.

outcome criteria Bilirubin levels usually decrease by 3 to 4 mg/dL in the first 8 to 12 hours of therapy. Thus simple jaundice clears rapidly. Excess bilirubin and jaundice that are the result of hemolytic disease or infection may be controlled with phototherapy, but the underlying cause is treated separately. Recovery is usually complete. The long-term safety of phototherapy has not been established. Short-term efficacy and practicality of use are certain.