A nurse is collecting data from a newborn and notes a swollen area on the head that does not cross the suture line. The nurse should document this finding as which of the following?

Choice A rationale:

Cephalhematoma is the correct answer because it presents as a swelling on the newborn's head confined to one cranial bone and does not cross suture lines. It usually resolves on its own within a few weeks to months but can increase the risk of jaundice due to the breakdown of red blood cells in the hematoma.

Choice B rationale:

Nevus flammeus, also known as a port-wine stain, is a type of vascular birthmark. It presents as a flat, pink, or red mark on the skin and does not involve swelling of the head. This choice is unrelated to the findings described in the question and is therefore incorrect.

Choice C rationale:

Caput succedaneum refers to a diffuse, soft tissue swelling of the scalp that does cross suture lines. It is caused by pressure on the head during delivery, leading to edema and bruising. It typically resolves within a few days after birth.

Choice D rationale:

Molding refers to the shaping of the fetal head during childbirth as it passes through the birth canal. It may cause temporary elongation or molding of the head, but it does not present as a localized swollen area. This choice is not applicable to the findings mentioned in the question and is thus incorrect.

Choice A: Warm the bottle in the microwave.

• Rationale: Warming bottles in the microwave is not recommended. Microwaving can cause uneven heating, creating hot spots in the milk or formula that can burn the baby's mouth. Instead, bottles should be warmed by placing them in a container of warm water or using a bottle warmer.

Choice B: Store prepared bottles in the refrigerator.

• Correct
• Rationale: Prepared bottles of formula should be stored in the refrigerator to prevent bacterial growth. Formula should be used within 24 hours of preparation when properly stored in the refrigerator.

Choice C: Discard unused formula in used bottle after 2 hours.

• Correct
• Rationale: Any unused formula that has been in contact with the baby’s mouth should be discarded after 2 hours due to the risk of bacterial contamination. Bacteria from the baby's saliva can grow in the leftover formula.

Choice D: Never prop a bottle.

• Correct
• Rationale: Bottles should never be propped up and left in the baby’s mouth. This practice increases the risk of choking, ear infections, and tooth decay. Caregivers should always hold the bottle and the baby during feedings.

Choice E: Formula is available in three forms.

• Correct
• Rationale: Formula is available in three forms: powdered, concentrated liquid, and ready-to-feed. Parents should be informed of these options so they can choose the most convenient or appropriate form based on their needs.