A nurse is caring for a 2-year-old child who has Clostridium difficile. Which of the following actions should the nurse take?

Rationale:

A. Place eye covers on the newborn while under the lights: Eye protection is essential during phototherapy to prevent retinal damage from the high-intensity blue light. The covers should be properly fitted and removed only during feedings or when the therapy is paused.

B. Apply an emollient lotion to skin that is exposed to the lights: Emollients are not recommended during phototherapy because they can increase the risk of burns or interfere with light penetration. The newborn’s skin should remain clean and dry to ensure safety and effective treatment.

C. Remove all blankets, clothing and diapers while the newborn is under lights: While minimal clothing is used to expose as much skin as possible, the diaper is typically kept in place to protect the genital area and reduce the risk of contamination. Full removal is not necessary or recommended.

D. Keep the newborn as close to the light source as possible: The distance between the newborn and the phototherapy light should be within manufacturer guidelines. Moving the newborn too close can increase the risk of overheating or skin damage, so positioning must follow safety standards.

Rationale:

A. Shortness of breath when climbing stairs: Mild dyspnea is common in the third trimester due to the upward displacement of the diaphragm by the enlarging uterus. This is typically not a concerning sign unless it occurs at rest or is accompanied by other symptoms like chest pain.

B. Periodic numbness of the fingers: Numbness or tingling in the hands and fingers during pregnancy can be caused by carpal tunnel syndrome due to fluid retention. While uncomfortable, it is a benign and relatively common symptom that usually resolves postpartum.

C. Leukorrhea: Leukorrhea, or increased vaginal discharge, is a normal finding in late pregnancy. It helps prevent ascending infections and is only concerning if it becomes foul-smelling, itchy, or changes in color, which could indicate infection.

D. Blurred vision: Blurred vision during the third trimester can be a sign of pregnancy-induced hypertension or preeclampsia. It may indicate cerebral involvement or elevated blood pressure and requires immediate evaluation by the healthcare provider.