The client has a physician's order for Methylergonovine (Methergine) 0.2 mg by mouth every 6 hours for 24 hours.

The RN knows the reason for this order is to assist in controlling postpartum bleeding.

What is the total amount the patient will receive in mg in a 24-hour period?

Condition: Neonatal Jaundice.

2 actions:

Initiate phototherapy,

Encourage frequent breastfeeding or formula feeding.

2 parameters:

Serum bilirubin levels,

Blood glucose levels.

Rationale for correct condition: Neonatal jaundice is indicated by the elevated bilirubin levels and yellow discoloration of the skin and sclera. The newborn's symptoms of lethargy, decreased muscle tone, and poor feeding are consistent with jaundice. Jaundice is common in newborns and requires prompt treatment to prevent complications like kernicterus. The total bilirubin level of 15 mg/dL is significantly elevated and needs intervention.

Rationale for actions: Initiating phototherapy helps lower bilirubin levels by breaking down bilirubin in the skin. This treatment is effective and commonly used for neonatal jaundice. Encouraging frequent breastfeeding or formula feeding promotes regular bowel movements, which help eliminate bilirubin from the body. Adequate feeding is essential to reduce jaundice severity. Administering intravenous dextrose addresses hypoglycemia but does not directly treat jaundice. Performing a lumbar puncture is unnecessary unless sepsis is suspected. Naloxone is used for opioid withdrawal, not jaundice.

Rationale for parameters: Monitoring serum bilirubin levels tracks the effectiveness of phototherapy. This parameter is crucial for assessing jaundice severity and treatment response. Blood glucose levels should be monitored due to the initial low reading, ensuring the newborn's glucose levels stabilize. Respiratory rate is normal and not directly related to jaundice. Urine output monitors hydration but is less specific to jaundice. Heart rate is stable and not a primary focus.

Rationale for incorrect conditions: Neonatal hypoglycemia focuses on low blood glucose but doesn't explain jaundice. Neonatal sepsis presents with more systemic signs like fever or abnormal reflexes. Neonatal abstinence syndrome involves withdrawal symptoms from maternal substance use, not relevant here.

Choice A rationale

Focusing primarily on her own needs is characteristic of the taking-in phase, where the mother is more self-focused and recovering from the birth process.

Choice B rationale

Being very excited and talkative about the birth experience is also a trait of the taking-in phase, not the taking-hold phase.

Choice C rationale

Interest in learning about infant care indicates the taking-hold phase, where the mother becomes more focused on the baby's needs and her new role as a caregiver.

Choice D rationale

Relying on nursing staff for assistance is common in the taking-in phase, where the mother depends more on others for care.