A nurse is planning care for a newborn who has spinal bifida. Which of the following actions should be included in the plan of care?

A Physiological jaundice is a common condition in newborns characterized by yellow discoloration of the skin and sclerae due to elevated levels of bilirubin in the blood. It typically appears within the first few days of life, often peaking around 2 to 4 days after birth. B Jaundice within 24 hours of birth is pathological and may indicate the presence of maternal/newborn blood group incompatibility.

C Maternal cocaine abuse and D absence of vitamin K are not directly associated with the development of jaundice in newborns.

Correct Choices for Indicating Understanding:

• "I should make sure that my baby feeds 8 to 12 times per day."
• "My baby's stools should turn to a yellow color within the next day or two."
• "I should expect my breasts to become harder, warmer, and more tender when my milk comes in."

Rationale

• "Because of my baby's weight loss, I need to supplement with formula after breastfeeding."

  • This statement does not necessarily indicate an understanding of discharge teaching, as supplementation should only be done based on medical advice and not solely based on perceived weight loss.

• "I should make sure that my baby feeds 8 to 12 times per day."

  • This statement indicates an understanding of discharge teaching, as frequent feeding is important for newborns to ensure adequate nutrition and hydration, and to promote milk production in breastfeeding mothers.

• "I should cover my sore nipples with plastic-lined breast pads after every feeding."

  • This statement does not indicate proper understanding, as plastic-lined breast pads can retain moisture and increase the risk of infection. Instead, breathable pads or natural remedies are often recommended.

• "My baby's stools should turn to a yellow color within the next day or two."

  • This statement indicates an understanding of normal neonatal stool changes, as breastfed babies' stools typically transition to a yellow color within a few days of birth.

• "I can increase my milk supply by drinking more water."

  • While staying hydrated is important, this statement alone is insufficient for indicating a comprehensive understanding of increasing milk supply. Effective breastfeeding practices and frequent nursing are more directly impactful.

• "I should expect my breasts to become harder, warmer, and more tender when my milk comes in."

  • This statement indicates an understanding of the common experience of breast engorgement when milk comes in, which is a normal part of the breastfeeding process.