Nursing Diagnosis and Interventions for Jaundice

Jaundice is a yellow discoloration of the skin, the mucous membrane and the white of the eyes. Jaundice is most commonly found in babies and newborns. Jaundice newborn is an infant with a condition caused by the extensive amount of bilirubin in blood.

Jaundice newborn represents a large group of newborns, approximately 60% of full term (physiological or normal jaundice) and 90% of premature babies (jaundice of prematurity). There is also breastfeeding jaundice which occurs when a newborn is not getting enough milk to drink.

There are a number of possible causes for jaundice in babies and newborns. The most common cause is over-feeding with breast milk. Since the baby's liver is too small, it can rarely cope with the enzymes, present in the milk, especially if the baby is overfed. Other causes include diseases, anemia, or a physical defect in the liver.

Newborn jaundice usually lasts 10 -14 days and it retreats in reverse to the development process, legs looking normal first leaving the little face colored the longest. This process can last up to one month in the premature babies. The same may occur in the breast- fed babies, where the substances contained in mother's milk cause slower development of the enzymes responsible for the digestion of the bilirubin. This condition is called breast milk jaundice and it may take up to 12 weeks to improve.


Nursing Diagnosis for Jaundice and Nursing Intervention for Jaundice

1. Deficient Fluid Volume related to inadequate fluid intake, photo-therapy, and diarrhea.

Goal:
Adequate neonatal body fluids

Intervention:

• Record the number and quality of stools,
• Monitor skin turgor,
• Monitor intake output,
• Give water between breast-feeding or give bottle.

2. Hyperthermia related to the effects of phototherapy

Goal:
The stability of the baby's body temperature can be maintained

Intervention:

• Give a neutral ambient temperature,
• Keep the temperature between 35.5 ° - 37 ° C,
• Check vital signs every 2 hours.

3. Impaired skin integrity related to hyperbilirubinemia and diarrhea

Goal:
The integrity of the baby's skin can be maintained

Intervention:

• Assess skin color every 8 hours,
• Monitor direct and indirect bilirubin,
• Change position every two hours,
• Massage the area that stands out,
• Keep skin clean and moisture.

4. Anxiety related to medical therapy given to the baby.

Goal:
Parents know about treatment, symptoms can be identified to deliver the health care team.

Intervention:

• Review knowledge of the client's family,
• Give the cause of yellow health education, therapy and treatment process.
• Give health education on infant care to home.
  

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