A nurse is caring for a newborn who has hyperbilirubinemia and is receiving phototherapy.
Which of the following interventions should the nurse implement?
A.
Apply sunscreen to the newborn’s skin before placing under the lights.
B.
Cover the newborn’s eyes with eye shields or patches.
C.
Turn off the phototherapy lights during feedings.
D.
Keep the newborn fully clothed to prevent heat loss.
The Correct Answer and Explanation is:
The correct answer is B. Cover the newborn’s eyes with eye shields or patches.
Explanation:
Hyperbilirubinemia occurs when there is an excessive level of bilirubin in the blood, often causing jaundice, a yellowish discoloration of the skin and eyes. Phototherapy is a common treatment for newborns with hyperbilirubinemia. The therapy uses light to help break down bilirubin in the skin, making it easier for the baby’s body to eliminate it.
Eye Protection:
The correct intervention is to cover the newborn’s eyes with eye shields or patches during phototherapy. The light used in phototherapy can be harmful to the sensitive eyes of a newborn. Exposure to this intense light may cause damage to the retina, leading to temporary or even permanent vision problems. Therefore, placing protective eye shields ensures the baby’s eyes are shielded from direct exposure while still allowing the therapeutic light to work on the skin.
Option A: Applying sunscreen
Applying sunscreen to a newborn is not appropriate. Sunscreen is generally not recommended for infants under 6 months, as their skin is highly sensitive. The purpose of phototherapy is for the light to penetrate the newborn’s skin and help reduce bilirubin levels, so applying sunscreen would block the light’s effectiveness.
Option C: Turning off lights during feeding
Turning off the lights during feeding is not necessary. The goal of phototherapy is continuous exposure to light to reduce bilirubin levels effectively. Interruptions in the light exposure can decrease the therapy’s effectiveness. Feeding can occur while the phototherapy continues, as long as the baby remains under the light as much as possible.
Option D: Keeping the newborn fully clothed
Keeping the newborn fully clothed is inappropriate during phototherapy because maximum skin exposure is needed for the treatment to work. Instead, the baby should be undressed except for a diaper, allowing the light to reach as much skin as possible.
Thus, covering the eyes while ensuring proper skin exposure is the most critical intervention for effective and safe phototherapy.