A nurse is assisting in the initiation of phototherapy.
Which nursing action is indicated for the newborn?

Choice A rationale

This statement is incorrect. While lactational amenorrhea method (LAM) offers some protection, it is only highly effective under strict conditions: amenorrhea, exclusive breastfeeding, and less than six months postpartum. Ovulation can resume even while breastfeeding, so additional contraception is often necessary to prevent unintended pregnancy.

Choice B rationale

There is no scientific evidence to support the claim that taking birth control pills while breastfeeding increases the risk for breast cancer. This statement is false and should not be used to counsel the client. The primary concern with combined estrogen-progestin pills in lactating women is the potential suppression of milk supply.

Choice C rationale

Combined estrogen-progestin birth control pills are generally contraindicated or strongly discouraged during the initial weeks to months of breastfeeding. The estrogen component can decrease the quantity and quality of breast milk, potentially interfering with successful lactation. However, progestin-only pills are considered safe and not contraindicated.

Choice D rationale

Progestin-only birth control pills (the "mini-pill") are the preferred hormonal contraceptive for lactating clients. The absence of estrogen means they are less likely to negatively impact breast milk supply or composition. Progestin-only pills primarily work by thickening cervical mucus and inhibiting ovulation, offering effective contraception while minimizing risks to the breastfeeding infant.

Choice A rationale

The proper sequence for suctioning a newborn is the mouth first, then the nose, to prevent the newborn from aspirating secretions. Suctioning the nose first may cause the newborn to gasp, drawing pharyngeal secretions into the trachea and lungs, potentially leading to aspiration pneumonia or respiratory distress.

Choice B rationale

Depressing the bulb prior to insertion into the mouth or nose creates a negative pressure inside the bulb. Releasing the pressure after insertion will then effectively draw secretions into the bulb, achieving optimal suction. Inserting a non-depressed bulb will be ineffective for removing secretions.

Choice C rationale

The bulb syringe does not require lubrication with sterile water before use; it is intended for immediate use as a mechanical suction device. Lubrication could potentially introduce excess fluid into the newborn's airway or dilute secretions, which does not enhance the device's primary function of removing mucus.

Choice D rationale

The bulb should be placed gently into the sides of the newborn's mouth, rather than the center, to avoid stimulating the gag reflex. Placing it at the sides directs suction toward the cheeks and gums, facilitating the removal of secretions from the oral cavity without causing discomfort or vomiting.