A nurse is caring for a newborn 4 hr after birth. Which of the following actions should the nurse include in the plan of care to prevent jaundice?

A) Shivering:

Shivering is a physiological response to cold in which the body generates heat through involuntary muscle contractions. Placing a newborn under a radiant heat warmer helps prevent shivering by maintaining the infant's body temperature within a normal range, reducing the need for compensatory mechanisms such as shivering.

B) Basal metabolic rate reduction:

Basal metabolic rate reduction is not the primary purpose of placing a newborn under a radiant heat warmer. While radiant heat helps maintain body temperature, it does not directly affect the basal metabolic rate, which is the body's energy expenditure at rest.

C) Cold stress:

Placing a newborn under a radiant heat warmer helps prevent cold stress by providing a controlled environment that maintains the infant's body temperature within a normal range. Cold stress occurs when a newborn's body temperature falls below normal, leading to increased oxygen and glucose consumption, metabolic acidosis, and potential complications such as respiratory distress and hypoglycemia.

D) Brown fat production:

Brown fat production is a physiological response to cold exposure in newborns. Brown fat is a specialized type of fat tissue that generates heat when metabolized, helping newborns maintain body temperature during cold exposure. While brown fat production is important for thermoregulation in newborns, placing the infant under a radiant heat warmer primarily aims to prevent cold stress by providing external warmth, rather than stimulating brown fat production.

A) Increase the client's fluid intake:

While maintaining adequate hydration is essential for postpartum recovery, it is not the priority intervention in this situation. The client's increased blood loss requires immediate attention to prevent complications such as hemorrhage.

B) Prepare to administer oxytocic medication:

Oxytocic medication may be indicated to stimulate uterine contractions and control bleeding in postpartum clients experiencing excessive bleeding. However, before administering medication, assessing the client's condition and determining the cause of bleeding is necessary to ensure appropriate intervention.

C) Palpate the client's uterine fundus:

This is the priority nursing intervention. Saturating two perineal pads with blood in a 30-minute period suggests excessive bleeding, which could be due to uterine atony or other postpartum complications. Palpating the uterine fundus helps assess for uterine tone, position, and any signs of uterine atony. If the fundus is boggy or deviated from the midline, it indicates uterine atony and requires immediate intervention.

D) Assist the client on a bedpan to urinate:

While assisting the client with urination is important for comfort and prevention of urinary retention, it is not the priority intervention in this situation. Assessing and managing the cause of excessive bleeding take precedence to prevent further complications.