Care for the child uderphototherapy

lecture about care for the child underphototherapy

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1. PHOTOTHERAPY
Prepared By:
Dr/ lamiaa Ahmed Elsayed
[email protected]
Care for the infant under phototherapy

2. Phototherapy
Care for the infant under phototherapy

3. Out lines
•Definition of Phototherapy
•Causes of jaundice
•History about Phototherapy.
•Mechanism of Phototherapy
•List the benefits of phototherapy
•Factors Affecting On Efficacy of
phototherapy
•Side Effects of Phototherapy.
•Nursing Care for Infant Receiving
Phototherapy.
Care for the infant under phototherapy

4. Objectives:
1.Define phototherapy
2.List causes of jundice
3.Identify history of phototherapy
4.List Indication of phototherapy
5.Understand the mechanism of phototherapy
6.List the benefits of phototherapy
7.Identify the factors affecting on efficacy of phototherapy
8.Enumerate the side effects of phototherapy
9.Apply the nursing care for infant’s receiving phototherapy
Care for the infant under phototherapy

5. Care for the infant under phototherapy

6. What is phototherapy?
•Phototherapy (light therapy) is a
way of treating jaundice. Special
lights help break down the
bilirubin in your baby's skin so
that it can be removed from his
or her body. This lowers the
bilirubin level in your baby's
blood.
Care for the infant under phototherapy

7. What is phototherapy?
Application of fluorescent light to
the infant’s exposed skin used to
breakdown the bilirubin in the
skin
Care for the infant under phototherapy

8. Indication of phototherapy
•Treatment of Hyperbilirubinemia
• The phototherapy will help the liver to
process bilirubin, bringing your baby's level
down to normal
•Prevent Kernicturus
Care for the infant under phototherapy

9. Causes of Jaundice
•Breast-feeding jaundice: Breast-feeding
jaundice may occur when your baby does not
drink enough breast milk. It occurs in 5% to
10% of newborns. The jaundice symptoms are
similar to those of physiological jaundice, just
more pronounced. The jaundice indicates a
need for help with breast-feeding
Care for the infant under phototherapy

10. Causes of Jaundice
•Physiological jaundiceThis is the most
common cause of newborn jaundice and
occurs in more than 50% of babies. Because
the baby has an immature liver, bilirubin is
processed slower. The jaundice first appears
at 2 to 3 days of age. It usually disappears by 1
to 2 weeks of age, and the levels of bilirubin
are harmless
Care for the infant under phototherapy

11. Causes of jaundice
•Breast-milk jaundice Breast-milk jaundice
occurs in 1% to 2% of breast-fed babies. It is
caused by a special substance that some
mothers produce in their milk. This substance
causes your baby's intestine to absorb more
bilirubin back into his body than normal. This
type of jaundice starts at 4 to 7 days of age. It
may last 3 to 10 weeks. It is not harmful.
Care for the infant under phototherapy

12. Causes of Jaundice
•Blood group incompatibility (Rh or ABO problems If
a baby and mother have different blood types,
sometimes the mother produces antibodies that
destroy the newborn's red blood cells. This causes a
sudden buildup of bilirubin in the baby's blood. Rh
problems formerly caused the most severe form of
jaundice. However, they are now preventable if the
mother is given an injection of Rho GAM within 72
hours after delivery. This prevents her from forming
antibodies that might endanger other babies she has
in the future
Care for the infant under phototherapy

13. History of PHOTOTHERAPY
Care for the infant under phototherapy

14. Care for the infant under phototherapy

15. History of PHOTOTHERAPY
•The use of phototherapy was first discovered,
accidentally, at Rochford Hospital in Essex,
England. The ward sister (Charge Nurse) of the
premature baby unit
Care for the infant under phototherapy

16. Mechanism of action
•Bilirubin is a naturally occurring
molecule of the red blood cells. It is
released into the bloodstream when the
red blood cells break down. This is
normal and occurs often. Our livers
break down the bilirubin and it is
excreted.
Care for the infant under phototherapy

17. Mechanism of action-Continue
•Phototherapy (light treatment) is the process
of using light to eliminate bilirubin in the
blood. Your baby's skin and blood absorb
these light waves. These light waves are
absorbed by your baby's skin and blood and
change bilirubin into products, which can pass
through their system.
Care for the infant under phototherapy

18. Mechanism of action-Continue
•wavelength of 420-448 nm, oxidized the
bilirubin to biliverdin, a soluble product that
does not contribute to kernicterus
Care for the infant under phototherapy

19. Mechanism of action
•The phototherapy will help the liver to process
bilirubin, bringing your baby's level down to
normal
•The light waves convert the bilirubin to water
soluble nontoxic forms which are then easily
excreted. Every attempt should be made to
find out the cause of jaundice.
• The advantages of phototherapy are that it is
noninvasive, effective, inexpensive and easy
to use.
Care for the infant under phototherapy

20. MECHANISM OF
WORKING
Care for the infant under phototherapy

21. What are the benefits of
phototherapy?
• The jaundice can be treated
•preventing the need for more
invasive treatment and the serious
complications, which can occur if
excessive levels of bilirubin develop
Care for the infant under phototherapy

22. Benefits of phototherapy -Continue
•Phototherapy is a safe.
• Effective method of treatment.
•It provides the highest level of
therapeutic light available to treat your
baby. This is the same form of light
found in sunlight This is safer than
sunlight though, because it filters out
the harmful ultraviolet and infrared
energy.
Care for the infant under phototherapy

23. FACTORS AFFECTING EFFICACY OF
PHOTOTHERY
•1-TYPE OF LIGHT USED
•2-LIGHT INTENSITY
•3-SURFACE AREA OF SKIN EXPOSED TO LIGHT
•4- The distance of the light source from the
baby, the optimum distance being 35 - 50 cm
in conventional lights.
Care for the infant under phototherapy

24. Assessment should be Before
Phototherapy
•GA Of the baby
•Weight The baby
•Postnatal Age
•Types of Jaundice
•the level of jaundice
Care for the infant under phototherapy

25. Nursing Care for Infant
Receiving Phototherapy
Care for the infant under phototherapy

26. Nursing Care for Infant Receiving
Phototherapy
•Baby will need to be in an incubator whilst
under photo therapy to keep warm,
• The photo therapy unit will be placed over the
top of the incubator occasionally more than
one unit may be used. This can be switched
off when your baby needs to come out to be
fed
Care for the infant under phototherapy

27. Nursing Care for Infant Receiving
Phototherapy Cont’
Proper covering and shielding of gonad .
Assess skin exposure .
Proper position .
Care for the infant under phototherapy

28. Nursing Care for Infant Receiving
Phototherapy Cont’
Assess and adjust thermoregulation device .
Promoting elimination and skin integrity .
Hydration.
Care for the infant under phototherapy

29. Nursing Care for Infant Receiving
Phototherapy.
-Assure effective of phototherapy
-provide eye protection Eyes are covered with eye-
patches to prevent damage to the retina by the .

Care for the infant under phototherapy

30. Nursing Care for Infant Receiving
Phototherapy- continue
• Baby is placed naked 45 cm away from the
tube lights in a crib or incubator.
•If using closer, monitor temperature of the
baby.
•Baby is turned every two hours or after each
feed.
Care for the infant under phototherapy

31. Nursing Care for Infant Receiving
Phototherapy
•During phototherapy, the
bilirubin level in your baby’s
blood will be checked at least
once every day. Phototherapy is
stopped when the bilirubin level
decreases.
Care for the infant under phototherapy

32. Nursing Care for Infant Receiving
Phototherapy
•Temperature is monitored every two to four
hours.
–Weight is taken at least once a day.
–More frequent breastfeeding or 10-20% extra
fluid is provided.
–Urine frequency is monitored daily.
• Serum bilirubin is monitored at least every 12
hours.
• Phototherapy is discontinued if two serum
bilirubin values are < 10 mg/dl.
•
Care for the infant under phototherapy

33. Nursing Care for Infant Receiving
Phototherapy
•Baby should spend as much time as possible
under the phototherapy lights for it to be
most effective, but your baby can come out
for feeding or cuddles if he or she is upset.
•Baby will need to have regular (usually daily)
blood tests whilst under photo therapy to
assess the levels of bilirubin and ensure the
phototherapy is effective.
Care for the infant under phototherapy

34. Nursing Care for Infant Receiving Phototherapy
Cont’
Promoting infant parent interaction.
Care for the infant under phototherapy

35. Side effect of phototherapy
•Bronze – baby syndrome.
•Loss , greenish stool .
•Transient skin rashes.
•Hyperthermia .
•Increasing metabolic rate.
•Dehydration .
•Electrolyte disturbance .
Care for the infant under phototherapy

36. •Thank You For your Attention
Care for the infant under phototherapy