Nursing Care of Neonatal Jaundice that Received Exchange Transfusion and Phototherapy

Abstract

Neonatal jaundice is a common condition of neonates and the incident rate increases. The surveillance and proper management, especially in neonates who have high level of bilirubin help to prevent the complication of acute bilirubin encephalopathy and kernicterus. Standard treatment is usually started with phototherapy. Exchange transfusion is performed when the bilirubin continue rising to a level that encephalopathy is considered a threat. Case study, neonatal male 3,080 gram 5 days old with jaundice, The neonatal has body temperature 36.8 °C, pulse rate 130 beats per minute, respiration rate 48 breaths per minute, good suckling and active. Laboratory results showed that total serum bilirubin 26 mg/dl, Hematocrit (Hct) 50%. The neonatal received exchange transfusion and after exchange transfusion, total serum bilirubin was 18 mg/dl and Hct 48%. Continue phototherapy until total serum bilirubin levels are within acceptable range. On phototherapy 3 days, laboratory results showed that total serum bilirubin 12.5 mg/dl, Hct 50%. Finally, neonatal was discharged from pediatric ward and follow up at pediatric clinic in 2 days from discharge. Length of stay was 5 days.