NICU nurses - phototherapy?

[Isitpossible, LPN, LVN]

Hi Nicu nurses!

I am a currently a student very interested in the NICU...i had my one and only nicu rotation this weekend. i had one question...according to my maternal book, it says that babies with jaundice who are receiving phototherapy should have eyes covered, repostioned every 2 hours, and removed from phototherapy at least every 4 hours. there was one baby in NICU receiving the phototherapy: never was repositioned for the 7 hours i was there nor removed from the therapy..of course i did not mention at clincal (dont wish to step on anyones toes) but i was just wondering if this is common?

thanks!

[I'mANurse!]

Do you know the gestation of this baby? Many times micropreemies are under therapy, but are too unstable to be moved constantly, especially if they were just born, as their risk for developing intraventricular hemorrhage at this time is extremely high. In these cases, minimal handling is best. The eyes should always be covered though. If it is a larger baby, and/or one that is being fed, they are turned more frequently and get breaks from phototherapy during their feeds or brief holding by parents.

[ittybabyRN, RN]

I don't think so...when I have a kiddo on phototherapy I shut the lights off with cares, take off the eye shields & check for breakdown. We don't really reposition every 2 hrs, just with cares which could be q3 or q4 depending on the baby, in my unit these are typically the very premature/sick babies who can't handle being moved more than with cares anyways, definitely more than every 7 hrs tho!

[babyNP., APRN]

Sometimes the re-position can seem very minor that you might miss it...it could be as small as placing a folded sheet under one of the sides of the baby (under the nest) to shift the balance of weight, which is what you're looking to do with every baby, whether on phototherapy or not (well, I guess minus the babies being discharged). It doesn't take too much to shift the center of balance...

[BittyBabyGrower, MSN, RN]

We will leave the baby under the lights for long periods of time if they are micro preemies or a bigger kid with a really, really high bili (ie ABO or RH). They only time we will turn off the lights on these kids are for AM cares (if applicable), blood draws and if mom is BF, and even then we put a bili blanket on those kids. The repostioning q2 is old, old, old. You do want to turn off those lights at some point,like about, so that you can check skin, eyes, etc. Like I said, there may have been certain circumstances that you didn't know about :)