Phototherapy

• Phototherapy is the application of a special source of light to the infant’s exposed skin to promote bilirubin excretion by photoisomerization

  
• The best results of phototherapy occur within the first 4 to 6 hours and it is designed primarily for the treatment of moderate hyperbilirubinemia
• Indications for phototherapy include the treatment of hyperbilirubinemia, helping the liver process bilirubin, and preventing kernicterus
• Factors affecting the efficacy of phototherapy include the type of light used (blue fluorescent light or white fluorescent light), light intensity, surface area of skin exposed to light, and the distance of the light source from the baby
• Benefits of phototherapy include treating jaundice, preventing the need for more invasive treatment and serious complications, and providing a safe and effective method of treatment
• During phototherapy, nursing care involves positioning the phototherapy units close to the patient, exposing as much skin surface as possible to the light, covering the eyes with appropriate opaque eye covers, and reviewing daily fluid requirements
• Nursing care during phototherapy also includes maintaining a strict fluid balance chart, limiting breastfeeds to 20 minutes if bilirubin levels are high, monitoring vital signs and temperature regularly, and covering lipid lines with light-resistant, reflective tape
• Ensure that the phototherapy unit is turned off during the collection of blood for TSB/SBR levels to avoid photo-oxidation of bilirubin, and observe for signs of potential side effects
• Potential complications of phototherapy include overheating, water loss from increased peripheral blood flow and diarrhea, rash, retinal damage, and temporary lactose intolerance