A nurse is providing teaching to the parent of a newborn who is 1 day old and has a prescription for gavage feeding.
Which of the following information should the nurse include in the teaching?

Choice A rationale

Bilirubin levels are typically monitored by a healthcare professional and not by parents at home every 6 hours. The frequency of bilirubin checks for a newborn receiving home phototherapy is usually determined by the healthcare provider based on the infant's bilirubin trajectory and clinical status, often daily or as prescribed.

Choice B rationale

Offering glucose water to newborns is not recommended. Glucose water does not provide adequate nutrition and can interfere with successful breastfeeding or formula feeding by reducing the infant's appetite for nutrient-rich milk. Adequate hydration and nutrition are crucial for bilirubin excretion in jaundiced infants.

Choice C rationale

For biliblanket phototherapy, eye coverings are generally not necessary. The biliblanket emits light from a fiber optic pad that is wrapped around the infant's body, and the light does not directly shine into the baby's eyes, unlike traditional overhead phototherapy lights that require eye protection.

Choice D rationale

Removing the baby from the biliblanket for feedings is appropriate and encouraged. Intermittent breaks for feeding and bonding are permissible as long as the total duration of phototherapy prescribed by the healthcare provider is met. Frequent feedings promote bilirubin excretion through stools.

• Moderate maternal bleeding: Worsening condition. HELLP syndrome involves platelet consumption and liver dysfunction that can cause coagulopathy and bleeding risk. New or increased bleeding signals disease progression and possible disseminated intravascular coagulation (DIC).
• Client reports ringing in ears: Worsening condition. Tinnitus can be a sign of hypertensive encephalopathy or central nervous system involvement from severe preeclampsia/HELLP, indicating neurological deterioration.
• BP 180/100 mm Hg: Worsening condition. A significant increase from baseline hypertension signals uncontrolled blood pressure and heightened risk for stroke, organ damage, and progression of HELLP.
• Client reports sharp, stabbing abdominal pain: Worsening condition. This could indicate hepatic hematoma or infarction, a serious complication of HELLP syndrome due to liver injury.
• FHR 80/min with absent variability: Worsening condition. Fetal bradycardia with absent variability indicates fetal distress, often from placental insufficiency related to maternal vascular compromise.
• PT 12 seconds: Indication of improving condition. Normal prothrombin time (PT range ~11-13.5 seconds) suggests stable coagulation status, indicating no worsening coagulopathy or bleeding tendency at this moment.