Care for the child uderphototherapy

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  • Mechanism of phototherapy : light prompt bilirubin excretion
  • Care for the child uderphototherapy

    1. 1. PHOTOTHERAPY <ul><li>Prepared By: </li></ul><ul><li>Dr/ lamiaa Ahmed Elsayed </li></ul><ul><li>[email_address] </li></ul>Care for the infant under phototherapy
    2. 2. Phototherapy Care for the infant under phototherapy
    3. 3. Out lines <ul><li>Definition of Phototherapy </li></ul><ul><li>Causes of jaundice </li></ul><ul><li>History about Phototherapy. </li></ul><ul><li>Mechanism of Phototherapy </li></ul><ul><li>List the benefits of phototherapy </li></ul><ul><li>Factors Affecting On Efficacy of phototherapy </li></ul><ul><li>Side Effects of Phototherapy. </li></ul><ul><li>Nursing Care for Infant Receiving Phototherapy. </li></ul>Care for the infant under phototherapy
    4. 4. Objectives: <ul><li>Define phototherapy </li></ul><ul><li>List causes of jundice </li></ul><ul><li>Identify history of phototherapy </li></ul><ul><li>List Indication of phototherapy </li></ul><ul><li>Understand the mechanism of phototherapy </li></ul><ul><li>List the benefits of phototherapy </li></ul><ul><li>Identify the factors affecting on efficacy of phototherapy </li></ul><ul><li>Enumerate the side effects of phototherapy </li></ul><ul><li>Apply the nursing care for infant’s receiving phototherapy </li></ul>Care for the infant under phototherapy
    5. 5. Care for the infant under phototherapy
    6. 6. What is phototherapy? <ul><li>Phototherapy (light therapy) is a way of treating jaundice. Special lights help break down the bilirubin in your baby's skin so that it can be removed from his or her body. This lowers the bilirubin level in your baby's blood . </li></ul>Care for the infant under phototherapy
    7. 7. What is phototherapy? <ul><li>Application of fluorescent light to the infant’s exposed skin used to breakdown the bilirubin in the skin </li></ul>Care for the infant under phototherapy
    8. 8. Indication of phototherapy <ul><li>Treatment of Hyperbilirubinemia </li></ul><ul><li>The phototherapy will help the liver to process bilirubin, bringing your baby's level down to normal </li></ul><ul><li>Prevent Kernicturus </li></ul>Care for the infant under phototherapy
    9. 9. Causes of Jaundice <ul><li>Breast-feeding jaundice: Breast-feeding jaundice may occur when your baby does not drink enough breast milk. It occurs in 5% to 10% of newborns. The jaundice symptoms are similar to those of physiological jaundice, just more pronounced. The jaundice indicates a need for help with breast-feeding </li></ul>Care for the infant under phototherapy
    10. 10. Causes of Jaundice <ul><li>Physiological jaundice This is the most common cause of newborn jaundice and occurs in more than 50% of babies. Because the baby has an immature liver, bilirubin is processed slower. The jaundice first appears at 2 to 3 days of age. It usually disappears by 1 to 2 weeks of age, and the levels of bilirubin are harmless </li></ul>Care for the infant under phototherapy
    11. 11. Causes of jaundice <ul><li>Breast-milk jaundice Breast-milk jaundice occurs in 1% to 2% of breast-fed babies. It is caused by a special substance that some mothers produce in their milk. This substance causes your baby's intestine to absorb more bilirubin back into his body than normal. This type of jaundice starts at 4 to 7 days of age. It may last 3 to 10 weeks. It is not harmful. </li></ul>Care for the infant under phototherapy
    12. 12. Causes of Jaundice <ul><li>Blood group incompatibility (Rh or ABO problems If a baby and mother have different blood types, sometimes the mother produces antibodies that destroy the newborn's red blood cells. This causes a sudden buildup of bilirubin in the baby's blood. Rh problems formerly caused the most severe form of jaundice. However, they are now preventable if the mother is given an injection of Rho GAM within 72 hours after delivery. This prevents her from forming antibodies that might endanger other babies she has in the future </li></ul>Care for the infant under phototherapy
    13. 13. History of PHOTOTHERAPY Care for the infant under phototherapy
    14. 14. Care for the infant under phototherapy
    15. 15. History of PHOTOTHERAPY <ul><li>The use of phototherapy was first discovered, accidentally, at Rochford Hospital in Essex, England. The ward sister (Charge Nurse) of the premature baby unit </li></ul>Care for the infant under phototherapy
    16. 16. Mechanism of action <ul><li>Bilirubin is a naturally occurring molecule of the red blood cells. It is released into the bloodstream when the red blood cells break down. This is normal and occurs often. Our livers break down the bilirubin and it is excreted . </li></ul>Care for the infant under phototherapy
    17. 17. Mechanism of action-Continue <ul><li>Phototherapy (light treatment) is the process of using light to eliminate bilirubin in the blood. Your baby's skin and blood absorb these light waves. These light waves are absorbed by your baby's skin and blood and change bilirubin into products, which can pass through their system. </li></ul>Care for the infant under phototherapy
    18. 18. Mechanism of action-Continue <ul><li>wavelength of 420-448 nm, oxidized the bilirubin to biliverdin, a soluble product that does not contribute to kernicterus </li></ul>Care for the infant under phototherapy
    19. 19. Mechanism of action <ul><li>The phototherapy will help the liver to process bilirubin, bringing your baby's level down to normal </li></ul><ul><li>The light waves convert the bilirubin to water soluble nontoxic forms which are then easily excreted. Every attempt should be made to find out the cause of jaundice. </li></ul><ul><li>The advantages of phototherapy are that it is noninvasive, effective, inexpensive and easy to use. </li></ul>Care for the infant under phototherapy
    20. 20. MECHANISM OF WORKING Care for the infant under phototherapy
    21. 21. What are the benefits of phototherapy? <ul><li>  • The jaundice can be treated </li></ul><ul><li>preventing the need for more invasive treatment and the serious complications, which can occur if excessive levels of bilirubin develop </li></ul>Care for the infant under phototherapy
    22. 22. Benefits of phototherapy -Continue <ul><li>Phototherapy is a safe. </li></ul><ul><li>Effective method of treatment. </li></ul><ul><li>It provides the highest level of therapeutic light available to treat your baby. This is the same form of light found in sunlight This is safer than sunlight though, because it filters out the harmful ultraviolet and infrared energy. </li></ul>Care for the infant under phototherapy
    23. 23. FACTORS AFFECTING EFFICACY OF PHOTOTHERY <ul><li>1-TYPE OF LIGHT USED </li></ul><ul><li>2-LIGHT INTENSITY </li></ul><ul><li>3-SURFACE AREA OF SKIN EXPOSED TO LIGHT </li></ul><ul><li>4- The distance of the light source from the baby, the optimum distance being 35 - 50 cm in conventional lights. </li></ul>Care for the infant under phototherapy
    24. 24. Assessment should be Before Phototherapy <ul><li>GA Of the baby </li></ul><ul><li>Weight The baby </li></ul><ul><li>Postnatal Age </li></ul><ul><li>Types of Jaundice </li></ul><ul><li>the level of jaundice </li></ul>Care for the infant under phototherapy
    25. 25. Nursing Care for Infant Receiving Phototherapy Care for the infant under phototherapy
    26. 26. Nursing Care for Infant Receiving Phototherapy <ul><li>Baby will need to be in an incubator whilst under photo therapy to keep warm, </li></ul><ul><li>• The photo therapy unit will be placed over the top of the incubator occasionally more than one unit may be used. This can be switched off when your baby needs to come out to be fed </li></ul>Care for the infant under phototherapy
    27. 27. Nursing Care for Infant Receiving Phototherapy Cont ’ <ul><li>Proper covering and shielding of gonad . </li></ul><ul><li>Assess skin exposure . </li></ul><ul><li>Proper position . </li></ul>Care for the infant under phototherapy
    28. 28. Nursing Care for Infant Receiving Phototherapy Cont ’ <ul><li>Assess and adjust thermoregulation device . </li></ul><ul><li>Promoting elimination and skin integrity . </li></ul><ul><li>Hydration. </li></ul>Care for the infant under phototherapy
    29. 29. Nursing Care for Infant Receiving Phototherapy . <ul><li>-Assure effective of phototherapy </li></ul><ul><li>-provide eye protection Eyes are covered with eye-patches to prevent damage to the retina by the . </li></ul>Care for the infant under phototherapy
    30. 30. Nursing Care for Infant Receiving Phototherapy- continue <ul><li>Baby is placed naked 45 cm away from the tube lights in a crib or incubator. </li></ul><ul><li>If using closer, monitor temperature of the baby. </li></ul><ul><li>Baby is turned every two hours or after each feed. </li></ul>Care for the infant under phototherapy
    31. 31. Nursing Care for Infant Receiving Phototherapy <ul><li>During phototherapy, the bilirubin level in your baby’s blood will be checked at least once every day. Phototherapy is stopped when the bilirubin level decreases. </li></ul>Care for the infant under phototherapy
    32. 32. Nursing Care for Infant Receiving Phototherapy <ul><li>Temperature is monitored every two to four hours. </li></ul><ul><ul><li>Weight is taken at least once a day. </li></ul></ul><ul><ul><li>More frequent breastfeeding or 10-20% extra fluid is provided. </li></ul></ul><ul><ul><li>Urine frequency is monitored daily. </li></ul></ul><ul><li>Serum bilirubin is monitored at least every 12 hours. </li></ul><ul><li>Phototherapy is discontinued if two serum bilirubin values are < 10 mg/dl. </li></ul><ul><li>  </li></ul>Care for the infant under phototherapy
    33. 33. Nursing Care for Infant Receiving Phototherapy <ul><li>Baby should spend as much time as possible under the phototherapy lights for it to be most effective, but your baby can come out for feeding or cuddles if he or she is upset. </li></ul><ul><li>Baby will need to have regular (usually daily) blood tests whilst under photo therapy to assess the levels of bilirubin and ensure the phototherapy is effective. </li></ul>Care for the infant under phototherapy
    34. 34. Nursing Care for Infant Receiving Phototherapy Cont ’ <ul><li>Promoting infant parent interaction. </li></ul>Care for the infant under phototherapy
    35. 35. Side effect of phototherapy <ul><li>Bronze – baby syndrome. </li></ul><ul><li>Loss , greenish stool . </li></ul><ul><li>Transient skin rashes. </li></ul><ul><li>Hyperthermia . </li></ul><ul><li>Increasing metabolic rate. </li></ul><ul><li>Dehydration . </li></ul><ul><li>Electrolyte disturbance . </li></ul>Care for the infant under phototherapy
    36. 36. <ul><li>Thank You For your Attention </li></ul>Care for the infant under phototherapy
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