A nurse is calculating the estimated date of delivery for a patient who reports that the first day of her last menstrual period was August 10. Using Nägele’s Rule, what is the patient’s estimated date of delivery?

Choice A rationale
The nurse should close the newborn’s eyes before applying eyepatches. This is because the intense light used in phototherapy can harm the newborn’s eyes. Therefore, protective eye patches are used to shield the newborn’s eyes from the light while allowing the rest of the body to be exposed to the light. This helps to convert the bilirubin in the skin into a form that can be easily eliminated from the body.
Choice B rationale
Turning the newborn every 4 hours is not specifically related to phototherapy. While turning is important for preventing pressure ulcers, it does not directly impact the effectiveness of phototherapy. The primary goal of phototherapy is to expose as much of the newborn’s skin as possible to the light, which helps to reduce the level of bilirubin.
Choice C rationale
Applying hydrating lotion to the newborn’s skin prior to treatment is not recommended. The use of lotions or creams can block the light and reduce the effectiveness of phototherapy. The skin should be clean and free of any barriers to light penetration.
Choice D rationale
Providing the newborn with 15 mL glucose water after each feeding is not directly related to phototherapy. While maintaining hydration is important for all newborns, it does not specifically enhance the effectiveness of phototherapy for jaundice.

Choice A rationale
Rust-stained urine is not a normal finding in a full-term newborn and should be reported to the provider. However, it is not typically assessed upon admission to the nursery.
Choice B rationale
Subconjunctival hemorrhage, or a small red or pink spot on the white of the eye, can occur due to the pressure changes during the birth process. It is a harmless condition that does not affect the baby’s vision and does not require treatment.
Choice C rationale
Single palmar creases, also known as “simian lines,” can be a normal variation in hand creases. However, they are also associated with certain genetic conditions, such as Down syndrome, and should be reported to the provider.
Choice D rationale
Transient circumoral cyanosis, or bluish color around the mouth, can be a normal finding in newborns when they are cold or after crying. However, if it persists, it could indicate a problem with the baby’s heart or lungs and should be reported to the provider.