A nurse is providing teaching about comfort measures for breast engorgement to a client who is postpartum and is breastfeeding. Which of the following statements by the client indicates a need for further teaching?

a. "Place the retainer clip across the newborn's abdomen":

• This statement is incorrect and potentially dangerous. The retainer clip should be positioned at the level of the armpits to secure the harness straps. Placing it across the abdomen could cause abdominal injury in the event of sudden braking or a crash.

b. "Keep the car seat rear-facing until the newborn can sit unsupported":

• While this is generally true and important safety advice, it is not directly related to the positioning of the newborn in the car seat. Instead, it addresses the orientation of the car seat itself. Rear-facing car seats are safer for infants as they provide better protection for the head, neck, and spine in the event of a crash.

c. "Position the newborn at a 45-degree angle in the car seat":

• This is the correct recommendation. Newborns should be positioned at a 45-degree angle in the car seat to prevent their head from falling forward and potentially obstructing their airway. Many car seats come with angle adjusters or indicators to help achieve this optimal positioning.

d. "Place the shoulder harness straps below the level of the newborn's armpits":

• Placing the shoulder harness straps below the level of the newborn's armpits is incorrect. The straps should be positioned at or slightly below the level of the shoulders to provide proper restraint. Placing them too low increases the risk of the baby slipping out of the harness in the event of a crash.

A. Inserting an orogastric tube for decompression of the stomach is not indicated for a newborn receiving oxygen via hood therapy.
B. Placing the newborn in Trendelenburg position is not appropriate and can lead to complications such as increased intracranial pressure.
C. Removing the hood every hour for 10 minutes to facilitate bonding is not appropriate as it may compromise the effectiveness of oxygen therapy and disrupt the newborn's stability.
D. Maintaining oxygen saturations between 93% to 95% is an appropriate nursing action to ensure adequate oxygenation while avoiding the risk of oxygen toxicity.