During phototherapy for neonatal jaundice, what is an essential nursing consideration to prevent complications?

• A. Maintain adequate hydration and skin protection.
• B. Do not feed the infant during therapy.
• C. Avoid hydration to prevent diaper rash.
• D. Discontinue phototherapy if stool changes.

Answer: (A)

During phototherapy, the risk of dehydration and skin irritation increases because the infant’s skin is exposed to intense light and can lose more fluids, while the immature skin is prone to breakdown with prolonged exposure. The best nursing approach is to keep the baby well hydrated and protect the skin. This means encouraging regular feeds to maintain fluid intake and monitoring hydration signs, urine output, and overall intake, so dehydration doesn’t develop. It also means caring for the skin—keeping the skin clean and dry, protecting it from irritation and breakdown under the light, and using appropriate eye protection and diaper care to prevent rash from moisture. Feeding during therapy supports bilirubin excretion and helps prevent dehydration, so withholding feeds would raise the risk of dehydration and slow bilirubin elimination. Stool changes or changes in color do not dictate stopping phototherapy; the therapy continues until bilirubin levels reach a safe range.