MAY CASE STUDY - TOPIC: Fibreoptic phototherapy for neonatal jaundice.

Baby Faith is 18-hour old newborn born by spontaneous vaginal delivery to a 23-year-old gravida 2, para 1, blood type O-negative mother.

Uncomplicated pregnancy. Rupture of membranes 7 hours prior to delivery with clear fluid. APGARs 7 and 9. 

Mom states that breastfeeding-  is a struggle; baby has a poor latch and is easily frustrated. Mom has sore nipples.

General - Slightly lethargic, crying with exam, flexed posture, visible jaundice

Vital signs - T 37.3C/ 99.1F, HR 144, RR 48

HEENT - Fontanelle slightly depressed, eyes and ears normal set/shape, sclera yellow, palate intact, tongue with Epstein pearls, dry mucous membranes

Cardo/Respiratory - No murmur, pulses +2 bilaterally, breath sound clear

Gastrointestinal/Genitourinary - Soft, non-distended, liver palpable, umbilical stump intact/clamped; passed 1 meconium stool, voided 1 time since birth.

The client is most likely experiencing:

• Breastfeeding jaundice

• Pathological jaundice

• Physiological jaundice

Due to:

• Poor breastmilk intake

• Hemolysis

• Impaired excretion

• Infection

Select the nursing action(s) from each of the categories the nurse should anticipate including in the plan of care. Each category may have one or more nursing action(s).

Therapy - Phototherapy

• Apply Eye shield
• Monitor temperature hourly
• Start/Practice? Kangaroo care
• Monitor phototherapy light level

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Therapy - Nursing

• Contact Lactation consultant
• Encourage breast feeding every hour
• Supplement feedings with infant formula
• Weigh diapers

See All Options

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What is the most serious complication of neonatal jaundice?

• A - Anemia
• B - Kernicterus
• C - Infection

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