Neonatal Nurse Practitioner Practice Exam

Which condition contraindicates the use of phototherapy?

1. Breast milk jaundice

2. Congenital erythropoietic porphyria

3. Hemophilia

The correct answer is: Congenital erythropoietic porphyria

Phototherapy is a common treatment for hyperbilirubinemia in newborns, but certain conditions can make its use contraindicated. In the case of congenital erythropoietic porphyria, this genetic disorder affects the body's ability to produce heme, a component of hemoglobin, leading to a buildup of porphyrins in the fetal and newborn tissues. The use of light therapy can exacerbate this condition because the light can react with the porphyrins, potentially leading to skin damage, worsening photosensitivity, and other systemic complications. In contrast, conditions like breast milk jaundice and hemophilia do not serve as contraindications for phototherapy. Breast milk jaundice is a common and usually benign condition stemming from factors in breast milk that inhibit bilirubin conjugation but is not harmful in the context of phototherapy. Similarly, while hemophilia requires caution with invasive procedures and potential bleeding risks, it does not negatively interact with phototherapy as there is no direct harm from light exposure. Understanding these distinctions is critical for neonatal care professionals when deciding on treatment strategies for hyperbilirubinemia while ensuring the safety and well-being of newborns.