An infant with hyperbilirubinaemia is receiving phototherapy. What intervention should the nurse implement?

• A. Maintain NPO status.
• B. Monitor temperature.
• C. Apply skin lotion as prescribed.
• D. Change T-shirt every 3 hours.

Answer: (B)

Phototherapy uses bright blue light to change bilirubin into a form that can be excreted, but the radiant heat from the lamps can affect an infant’s fragile thermoregulation. The newborn is especially prone to temperature fluctuations, and overheating can lead to dehydration, electrolyte imbalance, and skin trauma, while hypothermia can slow metabolism and complicate care. Therefore, closely monitoring temperature during treatment helps ensure the infant stays within a safe range and that phototherapy can be continued effectively.

In practice, this means checking the infant’s temperature regularly, often every 2 to 4 hours, and adjusting care as needed to maintain an neutral thermal environment. If the temperature rises, assess the setup—increase distance from the light, reduce exposure if clinically appropriate, or provide cooling measures and ensure adequate hydration and feeds. If the temperature drops, add warmth and recheck promptly. Throughout, continue to protect the eyes, promote adequate feeding to support hydration, and keep the skin exposed to the light as prescribed to maximize therapy.

NPO status isn’t indicated because maintaining hydration and normal feeding supports bilirubin elimination and overall stability. Skin lotion is not routinely used during phototherapy since it can interfere with light exposure and skin assessment. Keeping a T-shirt on or changing it frequently is not necessary and would reduce skin exposure to the light, which would diminish the effectiveness of therapy.