In which condition is phototherapy used for treatment?

RRB Nsg. Superintendent-20 July 2019 (Shift-1)

Child Health Nursing (Pediatrics)

Easy

Appeared in: RRB Nsg. Superintendent-20 July 2019 (Shift-1)

Explanation

Phototherapy is the primary and most effective treatment for neonatal jaundice (hyperbilirubinemia).
It involves exposing the infant's skin to blue-green light with a wavelength of approximately 460-490 nm.
The light energy converts toxic, unconjugated bilirubin in the skin into water-soluble, non-toxic isomers.
These isomers, primarily lumirubin, are then easily excreted in the urine and bile, lowering the overall bilirubin level in the body.

Option A: Cyanosis is caused by deoxygenated hemoglobin, resulting in a blue skin color. The treatment is oxygen administration and addressing the root cause, not light therapy.
Option B: While a different type of phototherapy (UV light) is used for severe skin conditions like eczema in adults, the term 'phototherapy' in the context of general and neonatal nursing specifically refers to blue-light treatment for jaundice.
Option C: Diarrhoea is a symptom of gastrointestinal distress, treated with fluid and electrolyte replacement. Phototherapy does not treat diarrhoea; in fact, loose stools can be a side effect of phototherapy.

Visual 1: Image - An infant under a phototherapy unit, clearly showing the blue light, eye patches, and minimal clothing (diaper only). This reinforces the key nursing interventions.
Visual 2: Diagram - A flowchart illustrating the mechanism of phototherapy, showing how unconjugated bilirubin is converted to lumirubin and other isomers and then excreted via the liver and kidneys.

Clinical Relevance

Nursing practice connection: Knowing Application of Phototherapy helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
A nurse's primary role during phototherapy is to ensure its effectiveness and monitor for potential side effects like dehydration, skin rash, temperature instability, and retinal damage.
Accurate monitoring of serum bilirubin levels is crucial to determine when to start and stop phototherapy, preventing both undertreatment (risk of kernicterus) and overtreatment.
What if? If an infant's bilirubin levels continue to rise rapidly despite intensive phototherapy, this indicates a more severe underlying condition (like severe hemolysis). The nurse must anticipate and prepare for the next line of treatment, which is an exchange transfusion.

How to Approach the Question

First, identify the key term in the question: 'phototherapy'.
Recall or deduce the primary clinical use of phototherapy in a general nursing context, which is overwhelmingly for neonatal jaundice.
Evaluate each option. 'Jaundice' is a direct match for the primary indication of phototherapy.
Systematically eliminate the other options by considering their standard treatments: Cyanosis requires oxygen, Eczema is a skin condition with different treatments, and Diarrhoea requires rehydration.
Confirm your choice by remembering that phototherapy works by breaking down bilirubin, the substance that causes the yellowing of the skin in jaundice.

Concept Tested & Keywords

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