A nurse is caring for a client at an outpatient clinic.

Select the 2 diagnostic tests the nurse should anticipate the provider to prescribe.

Rationale

• Supplement feeding with sterile water: Sterile water provides no nutritional value and dilutes electrolyte balance, increasing health risks without reducing bilirubin. It can interfere with adequate breast milk intake, which is essential for promoting bilirubin excretion. Hydration for jaundiced infants must come from breast milk or formula, not water.

• Dress in only a diaper: Phototherapy requires maximum skin exposure so bilirubin can be broken down effectively through light absorption. Limiting clothing allows more surface area to receive therapeutic light. Keeping only a diaper on also prevents overheating or obstruction from unnecessary garments. This setup ensures optimal treatment efficiency.

• Cover newborn’s eyes with a shield: The bright phototherapy lights can damage the newborn’s developing retina, so eye protection is essential. Soft shields prevent retinal injury while still allowing the infant to move comfortably. The shields are removed only during feeding or parent interaction to allow bonding. Consistent use is a critical safety component of phototherapy.

• Breastfeed every 2 to 3 hr: Frequent breastfeeding promotes bilirubin excretion through stooling and hydration, supporting the infant’s ability to lower bilirubin naturally. More frequent feeds also prevent lethargy from worsening and help maintain stable glucose levels. Breast milk intake is a key measure for preventing severe hyperbilirubinemia progression during phototherapy.

• Apply lotion to skin every 4 hr: Lotions can absorb heat and increase skin irritation under phototherapy lights. Some topical products may also intensify light absorption, raising the risk of burns. The newborn’s skin must remain clean and dry to prevent adverse reactions. Avoiding lotions keeps the skin safe during therapy.

A. Speak to a first-level manager about the social media post: Reporting the social media post to a first-level manager ensures that the situation is handled through proper administrative and professional channels. This protects client confidentiality, aligns with HIPAA regulations, and maintains professional accountability.

B. Gather additional information from other colleagues: Seeking additional information from peers may violate confidentiality and is not an appropriate method for addressing potential breaches of client privacy. The concern should be escalated through formal reporting channels rather than informal investigation.

C. Inform the client about the social media post: Directly informing the client may not be appropriate without guidance from administration or risk management, as it could complicate investigation or legal procedures. The issue should first be reported to management for proper handling.

D. Ask the colleague why the information was posted: Confronting the colleague directly could lead to defensiveness, workplace conflict, or compromised evidence. The appropriate first step is to report the concern to a supervisor rather than attempt immediate resolution with the colleague.