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Phototherapy And Bilirubin Monitoring: A Case Study

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Part B From the handover received on Max’s current condition, the following care plan was constructed for the upcoming early shift. Phototherapy and Bilirubin Monitoring Max’s SBR level of 300mmol/L at 60 hours old requires phototherapy treatment according to the SAPPG hour specific bilirubin chart (Image 2) (SAMNCN 2010). Following the recommendation of the ISBAR, phototherapy using a bilibed is to be commenced on the early shift. Seeing as Max is otherwise well, it is appropriate for him to remain in the open bassinet with correct monitoring whilst receiving phototherapy treatment via a bilibed (Flinders Women & Children Division 2014; QMNCGP 2012). Important points to consider when caring for a baby receiving phototherapy treatment include: ensuring correct skin care – washing with water only, no oils or creams used on exposed skin, ensuring the neonate is naked aside from a nappy and eye protection pads to maximise skin exposure to the lights and ensuring adequate hydration by monitoring fluid intake, urine output and observing stool consistency (RPAHNC 2005; Maisels, J 2006). Max’s SBR should be rechecked according to local protocol but generally 6 hours after phototherapy was commenced to assess the effectiveness of the phototherapy (QMNCGP 2012). It is vital to ensure phototherapy lights are…show more content…
It is important to closely monitor Max’s weight gain/loss daily and alter his feeding and treatment regimes accordingly (QMNCGP 2012). Seeing as Max has been tolerating his increased feeds well, the recommendation has been to further increase to 120mls/kg/day as he is now day 4 (Flinders Women & Children Division 2014). This means that each 3 hourly nasogastric tube feed will be 37.5mls (Flinders Women & Children Division
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