Nursing management during phototherapy

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.

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.

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.

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.

Skin Care:

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

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.

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.