Materiały źródłowe

• #1 Neonatal jaundice – MedCrave online

  https://medcraveonline.com/NCOAJ/neonatal-jaundice.html

  yellow discoloration of the skin and the mucosa is caused by accumulation of excess of bilirubin in the tissue and plasma (serum bilirubin level should be in excess 7mg/dl. 30-50% of term newborn and more of preterm newborns develop clinical jaundice.1 […] The goal of treatment of physiologic jaundice is to prevent the level of serum bilirubin from rising. Two type of therapy can be used for infants with physiologic jaundice; phototherapy and exchange transfusion. […] Certain precautions must be taken to prevent injury to the infant during the use of phototherapy. Since this treatment cause damage to the photoreceptors in the retina, the infant eyes must be shielded by an opaque mask. Eyes are checked frequently for evidence of infection. […] Nursing management includes providing proper care to baby and checking vital signs of the baby every hourly, maintaining fluid level and hygiene of child, and providing psychological support to parents, explain about follow up care. […] Phenobarbital is used prophylactically during pregnancy to prevent the occurrences of neonatal jaundice, especially when it is given for 2 weeks prior to the expected date of delivery. […] Assess fluid volume status of child by intake and output chart.

• #2 Nursing Care Plan for Jaundice: Promoting Optimal Health and Recovery – Made For Medical

  https://www.madeformedical.com/nursing-care-plan-for-jaundice-promoting-optimal-health-and-recovery/

  Jaundice is a common condition characterized by the yellowing of the skin and eyes, caused by the buildup of bilirubin in the body. […] As a nurse, your role is crucial in providing comprehensive care to patients with jaundice, aiming to manage symptoms, promote liver function, and facilitate recovery. Nursing care plays a crucial role in managing jaundice, alleviating symptoms, promoting recovery, and preventing complications. […] The initial step in providing effective care is a thorough assessment of the patients condition. […] Important assessments include evaluating the extent of jaundice, identifying the underlying cause, assessing liver function, and monitoring any associated symptoms. […] Based on the assessment, the following nursing diagnoses may be appropriate for a patient with jaundice: Impaired Skin Integrity related to increased bilirubin levels and pruritus.

• #3 Nursing Care Plan For Jaundice – Made For Medical

  https://www.madeformedical.com/nursing-care-plan-for-jaundice/

  Jaundice, a common clinical manifestation, is characterized by the yellowing of the skin, mucous membranes, and sclera due to the accumulation of bilirubin in the bloodstream. […] Nursing care for patients with jaundice is crucial to address the underlying causes, alleviate symptoms, and prevent complications. […] This nursing care plan is designed to provide comprehensive and patient-centered care for individuals with jaundice. […] Nursing interventions aim to promote early diagnosis, effective treatment, patient education, and symptom management. […] Nurses, as frontline healthcare providers, play a pivotal role in assessing and monitoring patients with jaundice, advocating for appropriate diagnostic tests and treatments, and educating patients and their families about the condition.

• #4 Nursing Care Plan for Jaundice: Promoting Optimal Health and Recovery – Made For Medical

  https://www.madeformedical.com/nursing-care-plan-for-jaundice-promoting-optimal-health-and-recovery/

  Jaundice is a common condition characterized by the yellowing of the skin and eyes, caused by the buildup of bilirubin in the body. […] As a nurse, your role is crucial in providing comprehensive care to patients with jaundice, aiming to manage symptoms, promote liver function, and facilitate recovery. Nursing care plays a crucial role in managing jaundice, alleviating symptoms, promoting recovery, and preventing complications. […] The initial step in providing effective care is a thorough assessment of the patients condition. […] Important assessments include evaluating the extent of jaundice, identifying the underlying cause, assessing liver function, and monitoring any associated symptoms. […] Based on the assessment, the following nursing diagnoses may be appropriate for a patient with jaundice: Impaired Skin Integrity related to increased bilirubin levels and pruritus.

• #5 Nursing Care Plan (NCP) for Neonatal Jaundice | Hyperbilirubinemia | Free NURSING.com Courses

  https://nursing.com/lesson/nursing-care-plan-for-hyperbilirubinemia-of-the-newborn-infant-jaundice-neonatal-hyperbilirubinemia

  Establish effective communication and collaboration between healthcare providers, including pediatricians, neonatologists, and nursing staff, to ensure a coordinated approach to monitoring and managing hyperbilirubinemia in the newborn. […] Monitor and document serum bilirubin levels regularly, paying close attention to trends and changes over time. […] Perform a thorough clinical assessment, including a physical examination to evaluate the extent and progression of jaundice. Note the presence of yellow discoloration in the skin and sclera. […] Identify and assess potential risk factors for hyperbilirubinemia, such as prematurity, ABO or Rh incompatibility, exclusive breastfeeding, and a family history of jaundice. […] Evaluate the infants feeding patterns, ensuring adequate intake and addressing any issues related to breastfeeding or formula feeding that may contribute to dehydration or insufficient caloric intake.

• #6 The care of the neonatal jaundice 新生兒黃疸的照護 | 衛教單張 – China Medical University Hospital

  https://www.cmuh.cmu.edu.tw/HealthEdus/Detail_EN?no=6117

  The care of the neonatal jaundice […] Causes of neonatal jaundice […] With neonates, benign jaundice tends to develop because of two factors – the breakdown of fetal hemoglobin as it is replaced with adult hemoglobin and the relatively immature hepatic metabolic pathways which are unable to conjugate and so excrete bilirubin as quickly as an adult. This causes an accumulation of bilirubin in the blood (hyperbilirubinemia), leading to the symptoms of jaundice. […] Whats neonatal jaundice? […] Most infants develop visible jaundice due to elevation of unconjugated bilirubin concentration during their first week. Neonatal jaundice is a yellowing of the skin and other tissues of a newborn infant. A bilirubin level of more than 5 mg/dL manifests clinical jaundice in neonates whereas in the adults 2 mg/dL would look icteric. In newborns jaundice is detected by blanching the skin with digital pressure so that it reveals underlying skin and subcutaneous tissue. In neonates the dermal icterus is first noted in the face and as the bilirubin level rises proceeds caudal to the trunk and then to the extremities.

• #7 Jaundice Nursing Management – RNpedia

  https://www.rnpedia.com/nursing-notes/medical-surgical-nursing-notes/jaundice-nursing-management/

  Jaundice is a symptom or syndrome characterized by increased bilirubin concentration in blood. It is classified as hemolytic, hepatocellular, or obstructive. […] Treat the underlying cause of jaundice (Hemolytic jaundice, hepatocellular jaundice and obstructive jaundice) […] Disturbed body image related to jaundice […] Impaired skin integrity related to hyperbilirubinemia. […] Assess and document degree of jaundice of skin and sclera. […] Intervene to reduce anxiety. Reinforce the health care providers explanation about the cause and expected outcome of jaundice, and encourage the client to express feelings and concerns about body-image changes. […] Promote adequate nutrition. Assess dietary intake and nutritional status. Encourage the client to adhere to a high-carbohydrate diet, with protein intake consistent with that recommended for hepatic encephalopathy.

• #8 Hyperbilirubinemia Symptoms, Treatment, Phototherapy, Care – LevelUpRN

  https://leveluprn.com/blogs/maternity-nursing/newborn-5-hyperbilirubinemia-symptoms-treatment-phototherapy-nursing-care?srsltid=AfmBOopi34U5TpGAap_L-G2wGyKHRex1OdMU45t4Eyufv8uN9NDFDxd4

  The nursing care associated with phototherapy to treat hyperbilirubinemia. […] Nursing care would be: we need to know when did the jaundice start, right? Was it before 24 hours of life or after? Big deal. And then, we need to provide care during phototherapy, which we will talk about in a minute. […] So lastly, let’s talk about phototherapy and what that entails from a nursing perspective. So phototherapy is placing the baby under UV lights, and that’s going to help to break down bilirubin. […] As with any sort of patient at all, we need to make sure that we’re turning them every two hours, right, so we don’t have pressure injuries. We need to monitor baby’s temperature. […] We would, of course, keep rechecking those bilirubin levels every 6 to 12 hours. […] We need to make sure baby is having all of their basic physiological needs met.

• #9 Nursing Care Plan (NCP) for Neonatal Jaundice | Hyperbilirubinemia | Free NURSING.com Courses

  https://nursing.com/lesson/nursing-care-plan-for-hyperbilirubinemia-of-the-newborn-infant-jaundice-neonatal-hyperbilirubinemia?parentId=1892693

  Monitor the frequency and characteristics of the infant’s bowel movements and urination to assess the elimination of bilirubin. […] Perform a focused neurological assessment to identify any signs of acute bilirubin encephalopathy or kernicterus, such as changes in muscle tone, irritability, poor feeding, or abnormal reflexes. […] Assess the newborn’s skin color and tone, particularly in areas where jaundice may be less apparent, such as the palms and soles. […] Actively engage with parents to gather information about any concerns they may have, address misconceptions, and provide education on the importance of monitoring and reporting changes in the infant’s condition. […] Initiate phototherapy as prescribed, ensuring the newborn is exposed to the therapeutic light source for the prescribed duration. Monitor the effectiveness of phototherapy by regularly assessing bilirubin levels.

• #10 Nursing Care Plan for Jaundice: Promoting Optimal Health and Recovery – Made For Medical

  https://www.madeformedical.com/nursing-care-plan-for-jaundice-promoting-optimal-health-and-recovery/

  Jaundice is a common condition characterized by the yellowing of the skin and eyes, caused by the buildup of bilirubin in the body. […] As a nurse, your role is crucial in providing comprehensive care to patients with jaundice, aiming to manage symptoms, promote liver function, and facilitate recovery. Nursing care plays a crucial role in managing jaundice, alleviating symptoms, promoting recovery, and preventing complications. […] The initial step in providing effective care is a thorough assessment of the patients condition. […] Important assessments include evaluating the extent of jaundice, identifying the underlying cause, assessing liver function, and monitoring any associated symptoms. […] Based on the assessment, the following nursing diagnoses may be appropriate for a patient with jaundice: Impaired Skin Integrity related to increased bilirubin levels and pruritus.

• #11 Jaundice Nursing Diagnosis and Nursing Care Plans – NurseStudy.Net

  https://nursestudy.net/jaundice-nursing-diagnosis/

  Jaundice is a condition characterized by yellowing of the skin and whites of the eyes due to elevated bilirubin levels in the blood. […] This nursing diagnosis is crucial for identifying and managing patients with jaundice, which can be a symptom of various underlying conditions affecting the liver, gallbladder, or blood cells. […] The following are common nursing care planning goals and expected outcomes for jaundice: The patient will demonstrate a reduction in yellow discoloration of skin and sclera. The patient will report relief from pruritus and other associated symptoms. The patient will maintain adequate nutrition and hydration. […] Nursing interventions are essential for managing jaundice and its underlying causes. […] Assess the patients skin and sclera color. Examine the patients skin and eyes for yellow discoloration. The intensity of jaundice can indicate the severity of the underlying condition.

• #12 Nursing Care Plan For Jaundice – Made For Medical

  https://www.madeformedical.com/nursing-care-plan-for-jaundice/

  A comprehensive nursing assessment for jaundice is crucial for identifying the underlying cause, assessing the severity of the condition, and developing an individualized care plan. […] Nursing diagnoses for jaundice guide the development of individualized care plans that address the physical, psychological, and educational needs of patients. […] Nursing interventions for jaundice aim to address the underlying causes, alleviate symptoms, and prevent complications while providing emotional support and education to patients and their families. […] The care plan outlined above acknowledges the diverse etiologies of jaundice and emphasizes the critical role of nursing interventions in addressing its underlying causes, alleviating symptoms, and preventing complications. […] Nursing care plans for jaundice serve as a guide to deliver compassionate and effective care, tailored to the unique needs of each patient.

• #13 Nursing Interventions for JaundiceNursing File | Nursing File

  https://nursingfile.com/nursing-care-plan/nursing-interventions/nursing-interventions-for-jaundice.html

  Assess the color of skin, sclera of eye and mucous membrane of mouth and nose every 8 hours. […] Check for any sign off complication and notify to physician. […] Check neurological status 8 hourly to identify complication of bilirubin encephalopathy. […] Check vital signs every 4 hourly. […] Monitor intake output and check urine and stool color. […] Administer medication as ordered. […] Control nausea and vomiting and administer anti-emetic drug as ordered. […] Monitor direct and indirect bilirubin to evaluate treatment efficacy. […] Provide healthy diet; consult with dietician. […] Give mouth care to increase appetite and prevent vomiting. Provide low fat diet. […] Encourage patient to take plenty of fluids(at least 6-8 glass daily) […] Check weight daily to evaluate weight loss or gain.

• #14 Nursing care of_hyperbilirubinemia | PDF

  https://www.slideshare.net/slideshow/nursing-care-ofhyperbilirubinemia-65591482/65591482

  Nursing care of newborn with Hyperbilirubinemia Hyperbilirubinemia is a condition in which the bilirubin level in the blood is increased. It is characterized by a yellow discoloration of the skin, mucous membrane, sclera, and various organs. The yellow discoloration is caused primarily by accumulation in the skin of unconjugated bilirubin, a breakdown product of hemoglobin forming after its release from hemolysed RBCs. […] Management of hyperbilirubinaemia: 1. Increase feeds in volume and calories. Early feeding lowers serum bilirubin level by stimulating the peristalsis. 2. Stop drugs interfering with bilirubin metabolism. 3. Correct hypoxia, infection, and acidosis. 4. Phototherapy. […] Nurses responsibility in phototherapy: 1. The lamp should be 5-8 cm over the incubator. 2. Continue the feeding. 3. Shield the newborn’s eyes. 4. Keep newborn naked except for the diaper area and change position frequently. 5. Cleanse skin frequently to prevent irritation. 6. Maintain adequate fluid intake to prevent dehydration and calculate intake and output. 7. Check newborn’s body temperature every four hours. 8. Weight newborn daily. 9. Observe skin, mucous membranes, and stool. 10. Bilirubin levels should be followed for at least 24 hours after discontinuing phototherapy.

• #15 Phototherapy for neonatal jaundice

  https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/phototherapy_for_neonatal_jaundice/

  All phototherapy units are to be set on high intensity at all times, regardless of the amount of units in use. This ensures delivery of adequate amounts of blue light via light emitting diodes (LEDs). […] Breastfed babies who require phototherapy should continue to breastfeed unless clinically contra-indicated due to other pathology; the neonates sucking, attachment and mothers milk supply should be monitored. In the case of infants nearing exchange transfusion level, the infant should not come out of phototherapy to feed as this is a medical emergency. All feeds should be given via a bottle or NGT if feeding is deemed safe. […] Daily fluid requirements should be reviewed and individualised for gestational and postnatal age. […] Explain to parents the need for and actions of phototherapy, particularly in relation to the need for skin surface to be exposed to the phototherapy light, and hence the need to care for neonates receiving phototherapy to be nursed in a neutral thermal environment. Potential complications of phototherapy and the need for protective eye coverings during phototherapy treatment should be explained.

• #16 Phototherapy for neonatal jaundice

  https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/phototherapy_for_neonatal_jaundice/

  All phototherapy units are to be set on high intensity at all times, regardless of the amount of units in use. This ensures delivery of adequate amounts of blue light via light emitting diodes (LEDs). […] Breastfed babies who require phototherapy should continue to breastfeed unless clinically contra-indicated due to other pathology; the neonates sucking, attachment and mothers milk supply should be monitored. In the case of infants nearing exchange transfusion level, the infant should not come out of phototherapy to feed as this is a medical emergency. All feeds should be given via a bottle or NGT if feeding is deemed safe. […] Daily fluid requirements should be reviewed and individualised for gestational and postnatal age. […] Explain to parents the need for and actions of phototherapy, particularly in relation to the need for skin surface to be exposed to the phototherapy light, and hence the need to care for neonates receiving phototherapy to be nursed in a neutral thermal environment. Potential complications of phototherapy and the need for protective eye coverings during phototherapy treatment should be explained.

• #17 Nursing care of_hyperbilirubinemia | PDF

  https://www.slideshare.net/slideshow/nursing-care-ofhyperbilirubinemia-65591482/65591482

  Nursing responsibilities: 1. Keep the newborn npo for 2-4 hours before exchange to prevent aspiration. 2. Check donor blood carts compatibility. 3. Keep resuscitation equipment at bedside: oxygen, ambo bag, endotracheal tubes, and laryngoscope. 4. Assist physician with exchange transfusion procedure. 5. Track amount of blood withdrawn and transfused to maintain balanced blood volume. 6. Maintain body temperature to avoid hypothermia and cold stress. 7. Monitor vital signs and observe for rash. 8. After transfusion, continue to monitor vital signs and check umbilical cord for bleeding or signs of infection. […] Expected Outcomes: Infant exhibits no signs of adverse effects from exchange transfusion. Vital signs remain within normal limits. There is no evidence of infection or bleeding at infusion site.

• #18 Nursing Interventions for JaundiceNursing File | Nursing File

  https://nursingfile.com/nursing-care-plan/nursing-interventions/nursing-interventions-for-jaundice.html

  Assess the color of skin, sclera of eye and mucous membrane of mouth and nose every 8 hours. […] Check for any sign off complication and notify to physician. […] Check neurological status 8 hourly to identify complication of bilirubin encephalopathy. […] Check vital signs every 4 hourly. […] Monitor intake output and check urine and stool color. […] Administer medication as ordered. […] Control nausea and vomiting and administer anti-emetic drug as ordered. […] Monitor direct and indirect bilirubin to evaluate treatment efficacy. […] Provide healthy diet; consult with dietician. […] Give mouth care to increase appetite and prevent vomiting. Provide low fat diet. […] Encourage patient to take plenty of fluids(at least 6-8 glass daily) […] Check weight daily to evaluate weight loss or gain.

• #19 Diet for jaundice recovery: What to eat and what to avoid

  https://www.medicalnewstoday.com/articles/321257

  People with jaundice can consume foods and drinks that help improve digestion and metabolism, protect the liver from further damage, and improve liver health. […] Jaundice indicates the liver is not working correctly. […] A person’s diet plays a significant role in jaundice recovery and prevention. […] The American Liver Foundation recommends eating a balanced diet that includes food from all food groups. Foods containing fiber are particularly beneficial. […] A doctor will provide an individualized treatment plan, including dietary suggestions, to someone with jaundice. […] Staying hydrated is one of the best ways to help the liver recover from jaundice. Water not only helps ease digestion but also helps the liver and kidneys flush out toxins. […] Fresh fruits and vegetables contain powerful antioxidants and fiber that can help limit liver damage during metabolism and ease digestion.

• #20 Newborn Jaundice: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.newborn-jaundice-care-instructions.uh4439

  Many newborn babies have a yellow tint to their skin and the whites of their eyes. This is called jaundice. […] If you are nursing, it may be normal for your baby to have very mild jaundice throughout breastfeeding. […] Babies with jaundice may need follow-up tests to check their bilirubin. […] Follow-up care is a key part of your child’s treatment and safety. […] Watch your newborn for signs that jaundice is getting worse. […] Breastfeed your baby often. Extra fluids will help your baby’s liver get rid of the extra bilirubin. […] If you use phototherapy to treat your baby at home, make sure that you know how to use all the equipment. […] Call your doctor now or seek immediate medical care if: Your baby’s yellow tint gets brighter or deeper. […] Watch closely for changes in your child’s health, and be sure to contact your doctor if: Your baby does not get better as expected.

• #21 A Practical Approach to Neonatal Jaundice | AAFP

  https://www.aafp.org/pubs/afp/issues/2008/0501/p1255.html

  Although jaundice is present in most newborns and is usually benign, it is imperative to carefully monitor newborns to identify those at risk of developing bilirubin-induced neurologic dysfunction. […] The approach to preventing this condition has changed over time. […] Physicians should encourage optimal breastfeeding (eight to 12 feedings per day) to decrease the incidence of hyperbilirubinemia. […] Physicians should liberally screen all infants for jaundice and risk factors. […] Bilirubin levels should be interpreted according to the infant’s age in hours. […] The key to secondary prevention is vigilance on the part of the health care team. […] All hospitalized newborns should be routinely monitored by nursing staff and physicians for the development of jaundice every eight to 12 hours, including at the time that vital signs are taken.

• #22 Phototherapy for neonatal jaundice

  https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/phototherapy_for_neonatal_jaundice/

  All phototherapy units are to be set on high intensity at all times, regardless of the amount of units in use. This ensures delivery of adequate amounts of blue light via light emitting diodes (LEDs). […] Breastfed babies who require phototherapy should continue to breastfeed unless clinically contra-indicated due to other pathology; the neonates sucking, attachment and mothers milk supply should be monitored. In the case of infants nearing exchange transfusion level, the infant should not come out of phototherapy to feed as this is a medical emergency. All feeds should be given via a bottle or NGT if feeding is deemed safe. […] Daily fluid requirements should be reviewed and individualised for gestational and postnatal age. […] Explain to parents the need for and actions of phototherapy, particularly in relation to the need for skin surface to be exposed to the phototherapy light, and hence the need to care for neonates receiving phototherapy to be nursed in a neutral thermal environment. Potential complications of phototherapy and the need for protective eye coverings during phototherapy treatment should be explained.

• #23 Phototherapy for neonatal jaundice

  https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/phototherapy_for_neonatal_jaundice/

  All phototherapy units are to be set on high intensity at all times, regardless of the amount of units in use. This ensures delivery of adequate amounts of blue light via light emitting diodes (LEDs). […] Breastfed babies who require phototherapy should continue to breastfeed unless clinically contra-indicated due to other pathology; the neonates sucking, attachment and mothers milk supply should be monitored. In the case of infants nearing exchange transfusion level, the infant should not come out of phototherapy to feed as this is a medical emergency. All feeds should be given via a bottle or NGT if feeding is deemed safe. […] Daily fluid requirements should be reviewed and individualised for gestational and postnatal age. […] Explain to parents the need for and actions of phototherapy, particularly in relation to the need for skin surface to be exposed to the phototherapy light, and hence the need to care for neonates receiving phototherapy to be nursed in a neutral thermal environment. Potential complications of phototherapy and the need for protective eye coverings during phototherapy treatment should be explained.

• #24 4 Hyperbilirubinemia (Neonatal Jaundice) Nursing Care Plans

  https://nurseslabs.com/hyperbilirubinemia-nursing-care-plans/

  Blood transfusion. Considering blood transfusion in severe cases of hyperbilirubinemia to remove excess bilirubin and provide additional red blood cells. […] Parent education. Educating parents about the causes, management, and signs of worsening hyperbilirubinemia, as well as the importance of follow-up care. […] Long-term follow-up. Planning for long-term follow-up to monitor the resolution of hyperbilirubinemia and identify any potential long-term effects or complications. […] Therapeutic interventions and nursing actions for patients with hyperbilirubinemia (jaundice) may include: Initiating Patient Education and Health Teachings. […] Provide parents with an appropriate written explanation of home phototherapy, listing technique and potential problems, and safety precautions. […] Discuss appropriate monitoring of home therapy, e.g., periodic recording of infants weight, feedings, intake/output, stools, temperature, and proper reporting of infant status.

• #25 Nursing Care Plan (NCP) for Neonatal Jaundice | Hyperbilirubinemia | Free NURSING.com Courses

  https://nursing.com/lesson/nursing-care-plan-for-hyperbilirubinemia-of-the-newborn-infant-jaundice-neonatal-hyperbilirubinemia

  Encourage and support breastfeeding, ensuring that the newborn is adequately fed. If necessary, supplement with formula to promote effective calorie intake and reduce the risk of dehydration. […] Implement a systematic monitoring plan for bilirubin levels, feeding patterns, and elimination. Document changes in clinical status, response to interventions, and any concerns raised by parents. […] Educate parents about the importance of phototherapy, feeding, and the significance of regular follow-up appointments. Provide clear instructions on recognizing signs of worsening jaundice or other concerning symptoms. […] Collaborate with pediatricians, neonatologists, and other healthcare team members to ensure a coordinated approach to care. Participate in regular team discussions to review the infants progress and adjust the care plan as needed.

• #26 Phototherapy for neonatal jaundice

  https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/phototherapy_for_neonatal_jaundice/

  This guideline applies to neonates within the first two weeks of life. Phototherapy is the use of visible light to treat severe jaundice in the neonatal period. Approximately 60% of term babies and 85% preterm babies will develop clinically apparent jaundice, which classically becomes visible on day 3, peaks days 5-7 and resolves by 14 days of age in a term infant and by 21 days in the preterm infant. Treatment with phototherapy is implemented in order to prevent the neurotoxic effects of high serum unconjugated bilirubin. Phototherapy is a safe, effective method for decreasing or preventing the rise of serum unconjugated bilirubin levels and reduces the need for exchange transfusion in neonates. […] This guideline provides health care providers with information to understand the causes of neonatal jaundice, the rationale for the use of phototherapy and outlines the care of neonates receiving phototherapy in order to enhance effective phototherapy delivery and minimise complications of phototherapy.

• #27 Jaundice in babies | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/healthyliving/jaundice-in-babies

  Treatment for jaundice in babies depends on the cause, but may include: […] mild jaundice if the baby is otherwise healthy and well, no treatment is necessary. […] moderate jaundice phototherapy is the most common treatment. […] severe jaundice sometimes babies need treatment with more than one blue light at a time (multiple phototherapy). […] Treatment for common conditions that cause jaundice may include: […] physiological jaundice often no treatment required, occasionally phototherapy is needed. […] breastmilk jaundice breastfeeding should be continued. […] blood group differences the antibodies made by the mother can remain active in the babys system for a few weeks. […] Treatments for rare conditions that cause jaundice may include: […] neonatal hepatitis there is no specific medical treatment.

• #28

  https://www.nuhs.edu.sg/patient-care/find-a-condition/jaundice-newborn

  Jaundice is the yellowish colour of the skin due to the presence of bilirubin (a breakdown product of red blood cells) which is removed from the bloodstream by the liver and excreted in the stools and urine. […] Physiological (normal) Jaundice occurs in more than half of all babies. Immaturity of the liver leads to a slower excretion of bilirubin. Jaundice first appears at 2 to 4 days of age, reaches it maximum level at about 4 -6 days of age, and disappears by 2 weeks of age. […] Breast milk Jaundice occurs later at 4 to 7 days of age, and may last from 3 to 10 weeks. […] When there are very high levels of bilirubin, babies may be excessively irritable, sleepy or disinterested in feeding. If left undiagnosed and untreated, the high Jaundice may damage the developing brain. […] Phototherapy may be needed in a small proportion of newborns before discharge, or you will be advised to bring your baby to the doctor within 24 – 72 hours after discharge to review your baby’s Jaundice and feeding pattern.

• #29 Breast Milk Jaundice Treatment & Management: Approach Considerations, Medical Care, Consultations

  https://emedicine.medscape.com/article/973629-treatment

  For healthy term infants with breast milk or breastfeeding jaundice who have bilirubin levels of 12 mg/dL (170 mol/L) to 17 mg/dL, the following options are acceptable: Increase breastfeeding to 8-12 times per day, and recheck the serum bilirubin level in 12-24 hours. Reassure the mother about the relatively benign nature of breast milk jaundice. […] Continue breastfeeding and supplement with formula. […] Temporary interruption of breastfeeding is rarely needed and is not recommended unless serum bilirubin levels reach 20 mg/dL (340 mol/L). […] For infants with serum bilirubin levels in the range of 17-25 mg/dL (294-430 mol/L), add phototherapy to any of the previously stated treatment options. […] The most rapid way to reduce the bilirubin level is to interrupt breastfeeding for 24 hours, feed with formula, and use phototherapy; however, in most infants, interrupting breastfeeding is not necessary or advisable.

• #30 Jaundice – La Leche League International

  https://llli.org/breastfeeding-info/jaundice/

  During the first week of life, more than half of all newborns have jaundice. Usually, jaundice is a normal part of adjusting to life outside the womb, but occasionally it may be a sign of serious health problems. Sometimes, the treatment of jaundice is challenging for mothers and babies. […] High levels in the first 24-48 hours after birth are termed pathological jaundice and likely to indicate an underlying medical problem. Levels that are rising quickly and high levels in premature or sick infants are also of special concern. Monitoring newborns’ bilirubin levels can help identify the underlying cause and enable early treatment. Breastfeeding generally can and should continue throughout treatment. […] The first step is to encourage the jaundiced baby to nurse more often (at least 10 to 12 times in 24 hours) and more effectively (check to see if baby is latched-on and sucking well) to reduce bilirubin levels as soon as possible.

• #31 Adult Jaundice: What It Is, Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/symptoms/15367-adult-jaundice

  Jaundice usually clears up once your healthcare provider treats your main medical condition. […] Your healthcare provider will also examine you to decide your liver’s size and tenderness. They may use imaging (ultrasound and CT scanning) and liver biopsy (taking a tissue sample of your liver) to better understand what’s causing your liver injury. […] There’s no specific treatment for jaundice. But your provider can treat the cause and the jaundice should improve. They can also treat complications the condition causes. […] A healthcare provider should evaluate jaundice. It’s a sign that something’s not right with your liver. If you notice signs of jaundice, call your healthcare provider. […] Keep in mind that jaundice is a sign of another health problem. That means your healthcare provider must treat your main illness before it clears up. […] Be sure to rest, eat balanced meals and drink plenty of fluids. Also, avoid any substance that strains your liver, like alcohol, herbal supplements or over-the-counter pain relievers.

• #32 Jaundice: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.jaundice-care-instructions.zc1011

  Jaundice is yellowing of your skin and the whites of your eyes. It’s caused by a pigment, or coloring, called bilirubin. This comes from the breakdown of red blood cells. When your liver is healthy, it removes the pigment from your blood. But if the liver isn’t working right, pigment can build up in the blood. Then it can get into the skin and other tissues. […] The treatment for jaundice depends on the cause. You may need medicine to treat an infection. Or you may need to have your gallbladder removed. Some people need to stop drinking alcohol. If another disease is causing jaundice, treating the disease usually takes care of the jaundice. If a medicine you take is causing jaundice, your doctor may switch you to another one. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.

• #33 Patient education: Jaundice in newborn infants (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/jaundice-in-newborn-infants-beyond-the-basics/print

  Jaundice is the medical term for a yellow-tinged coloring of the skin or mucous membranes (such as the thin inner lining of the eyes and mouth). The yellow color is caused by a natural pigment called bilirubin, which is a waste product that the body creates when it breaks down old red blood cells. It is normal for all babies to have an increase in their blood bilirubin levels during the first three to five days after birth. When bilirubin builds up in the skin and blood to levels that are higher than normal, babies develop jaundice. […] Jaundice is not a disease, but rather a sign of an elevated blood bilirubin level. The medical term for this is „hyperbilirubinemia.” […] If not treated, high bilirubin levels can lead to serious problems, including brain damage. For this reason, all babies should be checked for jaundice soon after birth. Babies who have signs of severe jaundice, such as jaundice during the first 24 hours after birth or yellowing of the palms of the hands and soles of the feet, require urgent testing to evaluate for severe hyperbilirubinemia.

• #34 Patient education: Jaundice in newborn infants (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/jaundice-in-newborn-infants-beyond-the-basics/print

  For the treatment to be successful, babies should have as much skin as possible exposed to the light. […] Phototherapy is usually stopped when bilirubin levels in the blood drop to a safe level. […] Breastfeeding during phototherapy — It is important for babies receiving phototherapy to drink adequate fluids (ideally breast milk) since bilirubin is eliminated in urine and stool. […] Babies who are not able to drink enough breast milk lose more weight than expected during the first week. […] Exchange transfusion — Babies whose bilirubin levels increase to toxic levels despite other treatments, or who have signs of or are at significant risk for brain damage, may need something called „emergency exchange transfusion.” […] Preventing severe hyperbilirubinemia is important to avoid serious life-long complications. […] Monitoring and prompt treatment — Parents, other caregivers, and healthcare teams should watch babies closely if jaundice develops. Timely identification and treatment are important to prevent serious complications of hyperbilirubinemia.

• #35 A Practical Approach to Neonatal Jaundice | AAFP

  https://www.aafp.org/pubs/afp/issues/2008/0501/p1255.html

  Although jaundice is present in most newborns and is usually benign, it is imperative to carefully monitor newborns to identify those at risk of developing bilirubin-induced neurologic dysfunction. […] The approach to preventing this condition has changed over time. […] Physicians should encourage optimal breastfeeding (eight to 12 feedings per day) to decrease the incidence of hyperbilirubinemia. […] Physicians should liberally screen all infants for jaundice and risk factors. […] Bilirubin levels should be interpreted according to the infant’s age in hours. […] The key to secondary prevention is vigilance on the part of the health care team. […] All hospitalized newborns should be routinely monitored by nursing staff and physicians for the development of jaundice every eight to 12 hours, including at the time that vital signs are taken.

• #36 A Practical Approach to Neonatal Jaundice | AAFP

  https://www.aafp.org/pubs/afp/issues/2008/0501/p1255.html

  Measurement and interpretation of the predischarge bilirubin level can help determine the timing of outpatient follow-up evaluations. […] Routine discharge counseling should include an explanation of monitoring for jaundice; this should ideally be provided in verbal and written formats. […] All newborn nurseries need to establish a protocol for identifying and evaluating hyperbilirubinemia. […] Some institutions with such a protocol report a reduced proportion of neonates with hyperbilirubinemia, its complications, and subsequent hospitalizations. […] Protocols should specify circumstances in which nurses can obtain bilirubin measurements. […] Routine supplementation with water or dextrose water is not recommended in breastfeeding infants because it will not prevent hyperbilirubinemia or decrease total serum bilirubin levels.

• #37 Discharge Instructions for Newborn Jaundice | Saint Luke’s Health System

  https://www.saintlukeskc.org/health-library/discharge-instructions-newborn-jaundice

  Your baby has jaundice. This is a short-term condition. But it can cause long-term problems if it’s not treated. […] Jaundice happens when your baby’s liver is still immature. The liver can’t help the body get rid of enough bilirubin. […] Almost half of all babies show some signs of jaundice, such as yellow skin or eyes. […] Watch your baby for signs of jaundice coming back or getting worse: Your baby’s skin or the whites of the eyes turns yellow. […] Breastfeed your baby often. Feed your baby at least 8 to 12 times every 24 hours. […] Arrange to have „bili lights” at home if your baby’s healthcare provider advises it. […] Call your baby’s healthcare provider if your baby has jaundice that gets worse (yellow color moving toward the feet). […] Call your baby’s healthcare provider if your baby has jaundice that doesn’t improve by 2 weeks of age.

• #38 Nursing Care Plan (NCP) for Neonatal Jaundice | Hyperbilirubinemia | Free NURSING.com Courses

  https://nursing.com/lesson/nursing-care-plan-for-hyperbilirubinemia-of-the-newborn-infant-jaundice-neonatal-hyperbilirubinemia

  Regularly assess and compare bilirubin levels to determine if they are decreasing within the expected range. Evaluate the effectiveness of phototherapy and other interventions in reducing bilirubin levels. […] Monitor the newborn for clinical signs of improvement, such as a decrease in jaundice, improved feeding patterns, and increased activity. Evaluate whether the infants overall condition is progressing positively. […] Assess the adequacy of feeding by monitoring weight gain, diaper output, and the infants overall nutritional status. Ensure that the newborn is receiving sufficient nutrition to support recovery. […] Evaluate parents understanding of the care plan, including the importance of phototherapy, feeding practices, and signs of worsening jaundice. Address any misconceptions and provide additional education if needed. […] Convene with the healthcare team to review the overall progress of the newborn. Discuss any challenges encountered during the implementation phase, make adjustments to the care plan as necessary, and ensure continued collaboration among team members.

• #39 Nursing care of_hyperbilirubinemia | PDF

  https://www.slideshare.net/slideshow/nursing-care-ofhyperbilirubinemia-65591482/65591482

  Nursing responsibilities: 1. Keep the newborn npo for 2-4 hours before exchange to prevent aspiration. 2. Check donor blood carts compatibility. 3. Keep resuscitation equipment at bedside: oxygen, ambo bag, endotracheal tubes, and laryngoscope. 4. Assist physician with exchange transfusion procedure. 5. Track amount of blood withdrawn and transfused to maintain balanced blood volume. 6. Maintain body temperature to avoid hypothermia and cold stress. 7. Monitor vital signs and observe for rash. 8. After transfusion, continue to monitor vital signs and check umbilical cord for bleeding or signs of infection. […] Expected Outcomes: Infant exhibits no signs of adverse effects from exchange transfusion. Vital signs remain within normal limits. There is no evidence of infection or bleeding at infusion site.

• #40 Nursing Care Plan (NCP) for Neonatal Jaundice | Hyperbilirubinemia | Free NURSING.com Courses

  https://nursing.com/lesson/nursing-care-plan-for-hyperbilirubinemia-of-the-newborn-infant-jaundice-neonatal-hyperbilirubinemia

  Communication and Education: Develop effective communication skills to educate parents about the causes, signs, and management of neonatal hyperbilirubinemia. Provide support and guidance for parents in caring for their jaundiced newborns at home. […] The primary goal is to reduce and maintain bilirubin levels within the normal range for the infants age, minimizing the risk of bilirubin-induced neurotoxicity. […] Achieve the resolution of jaundice, ensuring that the yellow discoloration of the skin and sclera diminishes as bilirubin levels decrease. […] Regular monitoring for potential complications, such as kernicterus or acute bilirubin encephalopathy, and promptly addressing any signs or symptoms to prevent long-term neurological damage. […] Provide thorough education to parents or caregivers regarding the importance of monitoring feeding, promoting adequate hydration, and recognizing signs of worsening jaundice. This empowers parents to actively participate in the care of their newborn.

• #41 Nursing Care Plan for Jaundice: Promoting Optimal Health and Recovery – Made For Medical

  https://www.madeformedical.com/nursing-care-plan-for-jaundice-promoting-optimal-health-and-recovery/

  Nursing care plays a vital role in managing jaundice, alleviating symptoms, promoting recovery, and preventing complications. Through a comprehensive assessment and the implementation of appropriate nursing interventions, nurses can enhance patient outcomes and optimize their overall health. […] By addressing skin integrity, managing fatigue, and providing education, nurses empower patients and their families to actively participate in their care, leading to a more effective and holistic approach to jaundice management.

• #42 Nursing Care Plan For Jaundice – Made For Medical

  https://www.madeformedical.com/nursing-care-plan-for-jaundice/

  A comprehensive nursing assessment for jaundice is crucial for identifying the underlying cause, assessing the severity of the condition, and developing an individualized care plan. […] Nursing diagnoses for jaundice guide the development of individualized care plans that address the physical, psychological, and educational needs of patients. […] Nursing interventions for jaundice aim to address the underlying causes, alleviate symptoms, and prevent complications while providing emotional support and education to patients and their families. […] The care plan outlined above acknowledges the diverse etiologies of jaundice and emphasizes the critical role of nursing interventions in addressing its underlying causes, alleviating symptoms, and preventing complications. […] Nursing care plans for jaundice serve as a guide to deliver compassionate and effective care, tailored to the unique needs of each patient.

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