Which of the following would the nurse include in the plan of care for a newborn receiving phototherapy? Select one:

Choice A Reason: Two arteries, one vein. This is because two arteries and one vein are the normal components of the umbilical cord, which is a structure that connects the fetus to the placenta and provides blood circulation between them. The umbilical cord carries oxygenated blood from the placenta to the fetus through the umbilical vein, and deoxygenated blood from the fetus to the placenta through the umbilical arteries.

Choice B Reason: Two veins, one artery. This is an incorrect answer that indicates an abnormal anatomy of the umbilical cord, which is known as single umbilical artery (SUA). SUA is a condition where there is only one umbilical artery instead of two, which can reduce blood flow and oxygen delivery to the fetus. SUA can be associated with congenital anomalies or growth restriction in some cases.

Choice C Reason: Two veins, two arteries. This is an incorrect answer that indicates an abnormal anatomy of the umbilical cord, which is known as double umbilical vein (DUV). DUV is a condition where there are two umbilical veins instead of one, which can increase blood flow and oxygen delivery to the fetus. DUV can be associated with fetal overgrowth or polycythemia in some cases.

Choice D Reason: One artery, one vein. This is an incorrect answer that indicates an abnormal anatomy of the umbilical cord, which is also known as single umbilical artery (SUA). SUA is a condition where there is only one umbilical artery instead of two, which can reduce blood flow and oxygen delivery to the fetus. SUA can be associated with congenital anomalies or growth restriction in some cases.

Choice A Reason: Applying Vaseline or lotion to newborn to maximize light absorption. This is an incorrect answer that indicates a contraindicated and harmful intervention that can interfere with phototherapy. Applying Vaseline or lotion to newborn can create a barrier or a reflective surface that can reduce the exposure and penetration of light to the skin, which can decrease the efficacy of phototherapy. Applying Vaseline or lotion to newborn can also cause skin irritation, infection, or burns, as it can trap heat and moisture under the light source.

Choice B Reason: Reducing the amount of fluid intake to 8 ounces daily. This is an incorrect answer that suggests a detrimental and dangerous intervention that can impair phototherapy. Reducing the amount of fluid intake to 8 ounces daily can cause dehydration, hypoglycemia, or electrolyte imbalance in newborns, which can worsen jaundice and increase the risk of complications such as kernicterus (brain damage due to high bilirubin levels). Reducing the amount of fluid intake to 8 ounces daily can also decrease the excretion of bilirubin through urine or stool, which can counteract the effect of phototherapy.

Choice C Reason: Keeping the newborn in the supine position. This is an incorrect answer that implies an incomplete and inadequate intervention that can limit phototherapy. Keeping the newborn in the supine position is a nursing action that involves placing the newborn on their back, which can expose their anterior body surface to light.

However, keeping the newborn in the supine position alone is not sufficient for phototherapy, as it does not expose their posterior body surface to light. The nurse should also reposition the newborn frequently to expose different body parts to light, such as their sides or abdomen.

Choice D Reason: Feeding every 3 hours to maximize intake of fluids and output. This is because feeding every 3 hours is a nursing intervention that can enhance the effectiveness and safety of phototherapy, which is a treatment that uses blue or white light to reduce the level of bilirubin in the blood. Bilirubin is a yellow pigment that is produced when red blood cells are broken down, which can cause jaundice (yellowish discoloration of the skin and mucous membranes) if it accumulates in excess. Phototherapy works by converting bilirubin into a water-soluble form that can be excreted through urine or stool. Feeding every 3 hours can increase the intake of fluids and calories, which can promote hydration, nutrition, and elimination of bilirubin.