Best Nursing Practice for Newborns with Jaundice - Essay Example

Neonatal Jaundice: Best Practice Guidelines The most common cause of jaundice in the full term new born is physiological jaundice. Other common causes include ABO incompatibility, Rh incompatibility and breast milk jaundice. In most babies with jaundice, only frequent breast feeding is sufficient. Mothers must be encouraged to feed the babies frequently and in cases of breast feeding insufficiency, formula milk must be started (Haynes, 2000). Whatever be the cause, after a certain level of bilirubin, based on the gestation, birth weight and duration after birth, intervention must be provided to treat jaundice.

The most common intervention is phototherapy which is initiated soon after the level of bilirubin reaches phototherapy zone. Infants receiving phototherapy need extra nursing care so that therapeutic phototherapy is provided and the baby does not feel chill or burn. Breast feeding is encouraged during phototherapy and some babies may benefit with fiberoptic pad underneath. The irradiation of the light must be measured. Nurses must maintain input and out because these babies are at risk of dehydration.

Daily weighing is another method of monitoring hydration. Nurses must also maintain temperature stability and skin intergrity. They must also monitor signs of irritation of the eyes. Linen of the babies must be changed frequently (Cohen, 2006). Nursing assessment with reference to these babies includes head size, evidence of birth trauma, feed intake, stooling, sleep patterns, irritability, lethargy and interaction with family. Serum bilirubin levels must be checked every 8, 12 or 24 hours based on the assessment.

Phototherapy must be discontinued when the bilirubin level falls less than 14 mg/dl. When bilirubin levels rise above 25 mg/dl, it is considered as medical emergency and the baby must be evaluated for exchange transfusion (AAP, 2005). Exchange transfusion must be done in neonatal intensive care unit only and infants undergoing this procedure must be monitored individually (Cogen, 2006). References American Academy of Pediatrics (AAP). (2004). Practice Parameter: Management of hyperbilirubinemia in the healthy term newborn.

Pediatrics, 94(4), 558-565 Cohen, S.M. (2006). Jaundice in the full-term newborn. Pediatric nursing, 32(3), 202- 208. Hayes, G. (2000). The jaundiced newborn: Minimizing the risks. Patient Care, 34(2), 45-56.