A nurse is applying a condom catheter to a male client who is incontinent. Which of the following is an appropriate technique to use?

• Maintain an opaque mask over the newborn's eyes when under the lights: Phototherapy can damage the retina due to prolonged light exposure. Properly fitted eye shields protect the eyes while allowing maximum skin exposure to the lights. The mask should be removed during feedings to assess the eyes for irritation or drainage.
• Monitor the frequency and consistency of stools: Phototherapy increases bilirubin excretion through stool, often causing loose, greenish stools. Monitoring stool patterns helps evaluate treatment effectiveness and detect dehydration. Increased stool frequency is expected as bilirubin levels decline. Ongoing assessment supports safe fluid balance management.
• Apply a mild, fragrance free lotion to exposed skin BID: Lotions and ointments can absorb heat and increase the risk of burns during phototherapy. Topical products may also block light penetration, reducing treatment effectiveness. The skin should remain clean and dry without barriers. Avoiding lotions ensures optimal bilirubin breakdown.
• Measure the occipital frontal-circumference (OFC) daily: Daily OFC measurement is indicated for concerns related to hydrocephalus or neurological abnormalities. This newborn’s primary issue is hyperbilirubinemia, not intracranial pathology. Caput succedaneum is already noted and does not require daily OFC monitoring unless head growth abnormalities are suspected.
• Offer glucose water supplements between feedings: Supplementing with glucose water can interfere with breastfeeding establishment and does not effectively reduce bilirubin levels. Adequate breast milk intake promotes bilirubin elimination through stool. Water supplementation may contribute to inadequate caloric intake and worsen weight loss
• Reposition the newborn every 2 to 3 hr: Frequent repositioning ensures maximum skin exposure to phototherapy lights and prevents pressure injury. Turning the newborn promotes even bilirubin breakdown across body surfaces. It also reduces the risk of skin irritation and supports comfort. Regular repositioning enhances treatment effectiveness.

A. Tachycardia: Opioid intoxication typically causes bradycardia rather than tachycardia due to central nervous system depression and increased parasympathetic activity. Elevated heart rate is more commonly associated with stimulant use or withdrawal states, not opioid intoxication.

B. Mental alertness: Opioids depress the central nervous system, leading to drowsiness, sedation, or stupor. Mental alertness is not consistent with opioid intoxication; instead, clients often present with decreased responsiveness and impaired cognition.

C. Hyperreflexia: Opioid intoxication generally causes decreased reflexes due to CNS depression. Hyperreflexia is more characteristic of stimulant intoxication or opioid withdrawal, not acute opioid toxicity.

D. Pinpoint pupils: Miosis, or constricted pupils, is a classic sign of opioid intoxication. Opioids stimulate the parasympathetic system via the Edinger-Westphal nucleus, causing the pupils to constrict. This is a reliable clinical indicator of opioid effects and is used in assessment of intoxication.