Possible diagnostic and intervention of nursing in newborns phototherapy

Abstract

Jaundice is represented by the change in pigmentation of the skin and mucosa due to hyperbilirubinemia, which is defined as the increased serum concentration of indirect bilirubin in the blood. It is very common in neonatology and can be classified as physiological or pathological. Its incidence is related to gestational age, type of food, race and geographical areas. Therapies indicated for the treatment of hyperbilirubinemia is phototherapy, exchange transfusion and drug treatment. Although phototherapy is simple and efficient, requires specific care and not without adverse reactions (complications), so it needs to be carefully monitored. The objective of this study is to identify the possible diagnoses and nursing interventions in newborns undergoing phototherapy. This is a descriptive and exploratory study of literature review, covering the period 2002-2013. Among the main complications of phototherapy described in the literature are: effects on intestinal transit, skin rash, hyperthermia, shock, burns, bronze baby syndrome, dehydration, retinal damage, lethargy, abdominal distension, metabolism acceleration, changes in red blood cells and damage to the nose or eyes due to the incorrect use of eye protection. The proposed nursing diagnoses are: risk for impaired skin integrity, risk for impaired tissue integrity, risk volume of poor liquid, risk of imbalance in the body temperature and risk of dysfunctional gastrointestinal motility. It can be considered that there are few publications about nursing diagnoses to neonates undergoing phototherapy, which shows the need to invest more in research. Although the diagnoses from actual cases have not been raised, it is believed that the findings can help nurses working in this area and can serve as a basis for possible comparisons with new research, thus allowing the establishment of scientific evidence more strengthened for the profession of nursing.