The student nurse learns that the process in which bilirubin is changed from a fat-soluble product to a water-soluble product is known as:

Choice A rationale

Wrapping the baby in warmed blankets addresses heat loss through conduction (direct contact with a cooler surface) and radiation (heat transfer to cooler surroundings). While helpful for maintaining warmth, it does not directly prevent heat loss from convection.

Choice B rationale

Convection is the loss of heat to cooler air currents moving across the skin surface. A blowing fan increases the rate of convective heat loss by continuously moving cooler air over the newborn. Moving the infant away from a blowing fan minimizes this heat transfer mechanism, thus preventing heat loss from convection.

Choice C rationale

Drying the baby after a bath primarily prevents heat loss through evaporation, as the evaporation of water from the skin surface cools the body. While important for thermoregulation, it does not directly address convective heat loss.

Choice D rationale

Placing the baby in a warmer, such as a radiant warmer, primarily prevents heat loss through radiation by providing a warm surface that emits infrared heat towards the infant. It also helps maintain the ambient air temperature, indirectly reducing convective heat loss, but moving away from a direct air current is the most direct way to prevent convection.

Step 1: Heart rate of 110/min scores 2 points (normal heart rate >100).

Step 2: Slow weak cry scores 1 point (good strong cry scores 2, no cry scores 0).

Step 3: Some flexion of extremities scores 1 point (active movement scores 2, limp scores 0).

Step 4: Grimace in response to suctioning scores 1 point (coughing or sneezing scores 2, no response scores 0).

Step 5: Body pink, blue extremities scores 1 point (completely pink scores 2, completely blue or pale scores 0).

Step 6: Total Apgar score is the sum of the scores from each category: 2 + 1 + 1 + 1 + 2 = 7. Final calculated answer: 7.