A newborn is being assessed for risk of hyperbilirubinemia. The infant has both caput succedaneum and a cephalohematoma. The nurse understands that phototherapy is more likely to be required in which condition, and why?

A. Provide scheduled analgesics and encourage nonpharmacologic strategies is correct. Children with sickle cell disease often experience recurrent pain episodes due to vaso-occlusion. Managing pain effectively involves scheduled analgesics, such as acetaminophen or opioids for severe pain, to maintain consistent relief, along with nonpharmacologic strategies like heat application, relaxation techniques, and distraction. This approach prevents pain escalation and improves quality of life.

B. Administer medication only when the child requests it is incorrect because children with chronic pain may underreport pain or wait until it is severe. Scheduled dosing ensures consistent pain control and prevents unnecessary suffering.

C. Limit physical activity to prevent pain episodes is incorrect because while extreme exertion can trigger a pain crisis, normal activity should be encouraged as tolerated to maintain mobility, muscle strength, and overall health. Over-restriction can negatively affect development and psychosocial well-being.

D. Encourage the child to ignore the pain is incorrect because ignoring pain can lead to delayed treatment, increased suffering, and potential complications such as prolonged vaso-occlusive crises. Pain should be acknowledged and managed appropriately.

A. Breast development is correct. Tanner staging evaluates thelarche, or breast development, which is a primary indicator of puberty in females. It is assessed on a scale from stage 1 (prepubertal) to stage 5 (mature adult).

B. Pubic hair growth is correct. Tanner staging also assesses pubarche, or the development of pubic hair, which progresses in predictable stages. This is independent of breast development and provides additional information about pubertal progression.

C. BMI is incorrect. While body mass index may influence the timing of puberty (higher BMI can be associated with earlier puberty), it is not part of the Tanner staging system, which focuses solely on physical sexual characteristics.

D. Hip girth is incorrect. Although hip widening occurs during puberty, Tanner staging does not include hip measurements. Physical observation focuses on breast and pubic hair development, not body proportions.

E. Age of menarche is correct. While menarche occurs later in puberty, knowing whether it has started helps determine the later Tanner stages (stage 4–5) and overall progression of puberty.