Nursing management during phototherapy

Nursing management during phototherapy focuses on maximizing the effectiveness of the treatment while ensuring the infant's safety and well-being.

1. Positioning and Light Exposure:

   • Ensure the infant's skin is maximally exposed to the phototherapy lights. This means removing all clothing except a diaper.
   • Reposition the infant every 2-3 hours to ensure all skin surfaces are exposed to the lights.

2. Eye Protection:

   • Keep the infant's eyes covered with opaque eye shields at all times during treatment.
   • Remove the eye shields periodically (e.g., every 4 hours or during feeding) to check for any signs of injury or discharge and to allow eye contact. Reapply immediately after.

3. Temperature Monitoring:

   • Monitor the infant's body temperature frequently (e.g., every 2-4 hours) as phototherapy can cause fluctuations.
   • Adjust the incubator or radiant warmer settings as needed to maintain a stable temperature.

4. Hydration and Nutrition:

   • Ensure adequate fluid intake. Phototherapy can increase insensible water loss.
   • Encourage frequent feedings (breastfeeding or formula) to promote bowel movements, which help excrete bilirubin.
   • Monitor for signs of dehydration, such as decreased urine output, dry mucous membranes, and sunken fontanelles.

5. Skin Care:

   • Inspect the infant's skin regularly for any signs of rash or burns.
   • Gently cleanse the skin as needed.

6. Bilirubin Monitoring:

   • Monitor the infant's bilirubin levels as per the healthcare provider's orders (e.g., every 12-24 hours).
   • Observe the infant's skin for any changes in color.

7. Documentation:

   • Record all nursing actions, the infant's vital signs, temperature, fluid intake/output, feeding status, and bilirubin levels.
   • Document the infant's response to phototherapy.