What should be the nursing focus when dealing with severe jaundice in a neonate?

When managing severe jaundice in a neonate, the primary nursing focus is initiating phototherapy. Phototherapy is a well-established treatment used to lower bilirubin levels in newborns by exposing them to specific wavelengths of light. This light helps to convert bilirubin into forms that can be more easily excreted by the body, thus reducing the risk of kernicterus, a serious condition that can result from very high levels of bilirubin.

The rationale for phototherapy lies in its effectiveness in treating hyperbilirubinemia, particularly in cases where levels are excessively high and can pose a risk to the neonate. The use of phototherapy is a critical intervention in preventing complications associated with severe jaundice.

While other options like encouraging breastfeeding can support bilirubin elimination through stooling, and monitoring oxygen levels or administering IV fluids may be relevant in different contexts of neonatal care, they are not the primary focus specifically for managing severe jaundice. Phototherapy directly targets the issue at hand, therefore it is the most appropriate and immediate nursing intervention in this situation.