Question

question 59 of 60
a nurse is caring for a 2 - day - old newborn who has a bilirubin level of 14 mg/dl (1 to 12 mg/dl) and is to begin phototherapy. which of the following actions should the nurse take?

• give glucose water after feedings.
• instruct the client to avoid breastfeeding during treatment.
• monitor intake and output.
• apply lotions and ointments throughout the treatment.

Explanation:

For a 2 - day - old newborn with a bilirubin level of 14 mg/dL (with a threshold of 12 mg/dL) and phototherapy:

• Giving plain water after feedings is incorrect as it can interfere with breastfeeding and hydration from breast milk.
• Instructing to avoid breastfeeding during treatment is wrong because breastfeeding is important for hydration and nutrition; phototherapy does not require avoiding breastfeeding.
• Monitoring intake and output is correct. Adequate fluid intake (from breastfeeding or formula) and output (urine, stool) are crucial as hydration helps in bilirubin excretion, and monitoring helps assess the newborn's fluid balance during phototherapy.
• Applying lotions and ointments throughout treatment is incorrect as they can interfere with the phototherapy lights' effectiveness.

Answer:

Monitor intake and output.