In the phototherapy the temperature of the baby should be monitored at every-

RUHS, Jaipur, PB B.Sc Nursing Entrance-2024

Child Health Nursing (Pediatrics)

Easy

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2024

Explanation

Infants receiving phototherapy are at high risk for temperature instability, including both hyperthermia (from the lights) and hypothermia (from being undressed).
Standard nursing protocol, as outlined in pediatric textbooks, is to monitor the neonate's temperature every 2 to 4 hours.
This frequency allows for timely detection and intervention to maintain a thermoneutral environment (36.5°C to 37.5°C).
The goal is to balance effective treatment with the prevention of complications related to body temperature.

Option A: While necessary for critically ill or unstable neonates, hourly temperature checks are generally too frequent for a stable infant under phototherapy, causing excessive disturbance.
Option C: This interval is too long. An infant's temperature can change significantly in this timeframe, leading to undetected hyperthermia or hypothermia, which can cause metabolic stress.
Option D: Checking the temperature only once a day is grossly inadequate and unsafe for any newborn receiving active medical treatment like phototherapy.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Nursing care and monitoring during phototherapy for neonatal jaundice as background academic context rather than a clinical decision trigger.
Thermoregulation is a critical nursing responsibility in neonatal care. Failure to maintain a stable temperature can lead to increased oxygen consumption, hypoglycemia, metabolic acidosis, and apnea.
Nurses must ensure the phototherapy unit is functioning correctly and placed at the manufacturer-recommended distance from the infant to provide effective treatment without causing overheating.
What if? If the infant is premature or shows signs of clinical instability (e.g., poor feeding, lethargy), the nurse should increase the monitoring frequency to every 1-2 hours and report any deviation from the normal range to the physician immediately.

How to Approach the Question

First, identify the key concept: the question asks for the standard frequency of temperature monitoring during phototherapy.
Recall the physiological principles of neonatal care, specifically their vulnerability to temperature instability.
Consider the effects of phototherapy: the lights produce heat (risk of hyperthermia), and the baby is undressed (risk of hypothermia).
Evaluate the options based on a balance between necessary surveillance and minimizing disturbance to the infant.
Eliminate the extremes: 'Morning' is clearly too infrequent and unsafe. 'Hour' is often too frequent for a stable baby and can be disruptive.
Choose between the remaining options. '2-4 hours' represents a standard, safe, and effective monitoring interval supported by clinical guidelines, whereas '4-6 hours' poses a risk of missing significant temperature changes.

Concept Tested & Keywords

Concept Tested: Nursing care and monitoring during phototherapy for neonatal jaundice.
Stem keywords: phototherapy, temperature, baby, monitored
Lead-in keywords: every

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