Daman & Diu Staff Nurse - 2018
Child Health Nursing (Pediatrics)
Easy
The goal of phototherapy in a newborn is?
Appeared in: Daman & Diu Staff Nurse - 2018
Explanation
- The primary goal of phototherapy is to reduce the level of unconjugated bilirubin in the blood.
- It utilizes blue-green light (460-490 nm) to convert toxic, fat-soluble unconjugated bilirubin in the skin into water-soluble isomers.
- These isomers, such as lumirubin, are non-toxic and can be excreted in urine and bile without needing to be conjugated by the liver.
- This process is essential for preventing high levels of unconjugated bilirubin from causing kernicterus, a serious form of brain damage.
Why Other Options Were Wrong
- Option A: Phototherapy does not have a direct effect on the respiratory system. Respiratory stability is managed through other interventions if needed.
- Option B: Phototherapy is ineffective for conjugated hyperbilirubinemia and is contraindicated. It acts on unconjugated bilirubin.
- Option D: This is a critical nursing care point during phototherapy, not the therapeutic goal of the treatment itself. The lights can cause temperature instability (both hypo- and hyperthermia).
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain The therapeutic goal and mechanism of phototherapy in neonatal jaundice as background academic context rather than a clinical decision trigger.
- Nurses are responsible for the safe administration of phototherapy, which includes maximizing skin exposure, protecting the infant's eyes, ensuring adequate hydration, and frequent repositioning.
- A key nursing role is monitoring for potential side effects, such as temperature instability, loose stools (from increased bile excretion), skin rashes, and dehydration.
- What if? If a newborn's jaundice persists or worsens despite phototherapy, or if they show signs of neurotoxicity (e.g., lethargy, high-pitched cry), the nurse must escalate care immediately. This could indicate severe hemolysis or another underlying condition requiring more aggressive treatment like an exchange transfusion.
How to Approach the Question
- First, identify the core concept of the question: the purpose of phototherapy for newborns.
- Recall the basic pathophysiology of neonatal jaundice: it is typically caused by an excess of unconjugated (indirect) bilirubin due to an immature liver.
- Analyze the options based on this knowledge. The treatment must target the cause of the problem.
- Eliminate options related to other body systems or general care. Respiratory stability (Option A) and temperature regulation (Option D) are important but are not the primary mechanism of the therapy.
- Differentiate between the two types of bilirubin. Since the problem is excess unconjugated bilirubin, the correct therapy must aim to decrease it. This makes Option C the most logical choice and rules out Option B.
Concept Tested & Keywords
- Concept Tested: The therapeutic goal and mechanism of phototherapy in neonatal jaundice.
- Stem keywords: phototherapy, newborn, goal
- Lead-in keywords: is
Question ID
QIUXgZVydwWs6MEoAaOpPP
Reference Book
E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 172-174
E6 Text Book Of Pediatric Nursing 3rd Panchali Pal — Part 1 (pp 36-238 of 713) p. 193-195
E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 1124-1126
Practise the full Daman & Diu Staff Nurse - 2018
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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