Which assessment finding in a newborn places them at risk for physiological jaundice?

Choice A rationale

A slurping or clicking sound indicates poor latching and is often associated with air entering the mouth due to improper seal or positioning of the infant. These sounds can reflect nipple misalignment or inadequate breast tissue placement into the infant's mouth, affecting milk transfer and leading to potential breastfeeding complications, such as nipple pain or reduced milk intake.

Choice B rationale

Audible swallowing confirms that the infant is successfully transferring milk and is properly latched. Proper latch allows efficient milk removal, which triggers swallowing reflexes. It reflects an absence of air entry and indicates that the infant is receiving milk without difficulty, promoting both nutritional intake and breastfeeding success.

Choice C rationale

The infant's tongue cupping under the breast with lips flanged ensures proper latch by creating a vacuum seal. This position prevents air leakage and allows effective milk transfer. Tongue cupping and lip flanging optimize compression of the lactiferous sinuses, supporting effective breastfeeding and minimizing discomfort for the mother.

Choice D rationale

Rhythmic sucking is a sign of coordinated latch and feeding. It reflects successful milk transfer and synchronization between suckling and swallowing. Rhythmic patterns reduce the risk of nipple trauma by ensuring proper placement and suction. This indicates that breastfeeding dynamics are efficient and beneficial.

Choice E rationale

Dimpling of the infant's cheeks occurs due to suction difficulties and often signifies improper latch or weak oral musculature. It leads to air leakage and insufficient milk removal. This finding may contribute to feeding inefficiencies and nipple trauma, indicating a need for latch correction.

Choice A rationale

Restricting play activity limits physical and emotional well-being in children. While strenuous activity is discouraged during recovery, moderate activity promotes overall health and blood flow. Over-restriction is unwarranted without clinical indications. Balance in physical activity should be emphasized in sickle cell management.

Choice B rationale

Cold compresses induce vasoconstriction, which may precipitate a sickle cell crisis by reducing oxygen delivery to tissues. Warm compresses are preferred to improve blood flow and alleviate pain in these patients. Temperature management is critical in preventing vaso-occlusive complications.

Choice C rationale

Adequate hydration reduces blood viscosity, preventing sickling episodes in children with sickle cell anemia. Consistent fluid intake is a cornerstone of management, mitigating crisis frequency. Parents should encourage routine hydration to maintain hemodynamic stability in affected children.

Choice D rationale

Daily temperature monitoring is important but not sufficient standalone advice. Fever in sickle cell anemia may indicate infection or crisis, requiring prompt medical evaluation. However, comprehensive management includes hydration, pain control, and activity regulation alongside temperature monitoring. .