What is the nursing priority when caring for a newborn with a high bilirubin level?

Initiating phototherapy as needed is the nursing priority when caring for a newborn with a high bilirubin level because this intervention directly addresses hyperbilirubinemia, which can lead to serious complications like kernicterus if not treated promptly. Phototherapy works by breaking down bilirubin in the skin and helping the baby's body eliminate it more effectively. It is a standard and critical treatment for jaundice in newborns, making it a primary focus of nursing care.

While monitoring for signs of dehydration, encouraging frequent feedings, and educating parents on follow-up care are all important aspects of managing a newborn's health, they are secondary to the immediate need to reduce bilirubin levels. Monitoring for dehydration is relevant, especially since jaundiced infants may have issues with feeding. Encouraging frequent feedings can help support bilirubin elimination through stool output, and educating parents is essential for ongoing care. However, these actions do not provide the immediate intervention that phototherapy does to prevent potential neurological damage from elevated bilirubin. Thus, the prompt initiation of phototherapy is paramount in this scenario.