Which precaution must a nurse take during phototherapy?

HPSSC - 2015

Child Health Nursing (Pediatrics)

Easy

Appeared in: HPSSC - 2015

Explanation

The primary safety precaution during phototherapy is to protect the infant's eyes from the high-intensity light used for treatment.
Continuous exposure to the blue-green light (460-490 nm wavelength) can cause significant and irreversible damage to the retina.
Nurses must apply opaque eye shields or patches, ensuring they fit snugly to block all light but do not put pressure on the eyes or obstruct the nostrils.
Eye shields are typically removed during feeding to allow for eye care, assessment for infection or discharge, and to facilitate parent-infant bonding.

Option A: Leaving clothes on significantly reduces the effectiveness of phototherapy. The treatment works by exposing the skin to light, which helps break down bilirubin.
Option B: This option is illogical and not a standard nursing practice. Clothes are removed for phototherapy, so there would be no clothes to 'check on'.
Option D: Infrequent repositioning is contraindicated. It would lead to uneven light exposure, reducing the treatment's overall effectiveness and potentially causing skin irritation or pressure sores on unexposed areas.

Clinical Relevance

Nursing practice connection: Knowing Nursing care and safety precautions during neonatal 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 balance treatment efficacy with patient safety, preventing complications like retinal damage, dehydration, and temperature instability.
Meticulous eye care is crucial. Nurses should remove eye patches during feeding for cleaning, assessment for infection or discharge, and to facilitate essential parent-infant bonding.
What if? If the infant has cholestatic (direct) hyperbilirubinemia, phototherapy can cause 'bronze baby syndrome,' a dark, grayish-brown discoloration of the skin. The nurse must report this to the physician immediately, as it indicates an underlying liver issue, though phototherapy may still be continued if the benefits outweigh the risks.

How to Approach the Question

Identify the core procedure in the question: phototherapy for a newborn.
Recall the purpose of phototherapy: to use light to break down excess bilirubin in the skin.
Consider the two main goals of nursing care for any procedure: maximizing effectiveness and ensuring patient safety.
Analyze the options through this lens. Which action is a critical safety measure?
Evaluate: Leaving clothes on (A) and repositioning infrequently (D) would decrease effectiveness. Checking clothes on (B) is illogical. Covering the eyes (C) directly addresses a major safety risk—retinal damage from the intense light.
Conclude that protecting the eyes is the most critical precaution among the choices.

Concept Tested & Keywords

Concept Tested: Nursing care and safety precautions during neonatal phototherapy.
Stem keywords: precaution, nurse, phototherapy
Lead-in keywords: Which

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