Page 832 - Saunders Comprehensive Review For NCLEX-RN

4. Report to the PHCP any signs of jaundice in the first
24 hours of life and any abnormal signs and
symptoms.
5. Prepare for phototherapy (bili-light or bili-blanket),
and monitor the newborn closely during the
treatment.

At any serum bilirubin level, the appearance of jaundice during

the first day of life indicates a pathological process.
D. Phototherapy

1. Description
a. Phototherapy is use of light to reduce
serum bilirubin levels in the newborn.
b. Adverse effects from treatment, such as
eye damage, dehydration, or sensory
deprivation, can occur.
2. Interventions
a. Follow specific instructions for
phototherapy and biliblanket care.
b. Expose as much of the newborn’s skin
as possible.
c. Cover the genital area, and monitor the
genital area for skin irritation or
breakdown.
d. Cover the newborn’s eyes with eye
shields or patches; ensure that the
eyelids are closed when shields or
patches are applied.
e. Remove the shields or patches at least
once per shift (during a feeding time)
to inspect the eyes for infection or
irritation and to allow for eye contact
and bonding with the parents.
f. Measure the lamp energy output to
ensure efficacy of the treatment (done
with a special device known as a
photometer).
g. Monitor skin temperature closely.
h. Increase fluids to compensate for water
loss.
i. Expect loose green stools.
j. Monitor the newborn’s skin color with
the fluorescent light turned off, every 4
to 8 hours.
k. Monitor the skin for bronze baby

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