A newborn was not dried completely after birth. This places the infant at risk for which of the following types of heat loss?

A. The mother cleans the newborn's eyes from the inner canthus outwards: This is the correct technique for cleaning the newborn’s eyes. It prevents contamination of the tear duct area by starting from the inner corner and moving outward to avoid spreading any debris or discharge from the eye.

B. The mother plans to use a cotton-tipped swab to clean the nares: This is not recommended because cotton-tipped swabs can be too harsh and might cause injury to the delicate nasal passages. The nurse should recommend using a bulb syringe to gently suction the nostrils if needed.

C. The mother leaves the yellow exudate on the circumcision site: Yellow exudate (fibrin) on a circumcision site is normal during the healing process, as it forms a protective layer. It should not be removed, as this could cause irritation or bleeding. This is a typical finding in the healing process and does not require intervention.

D. The mother cleans the umbilical cord with tap water: Cleaning the umbilical cord with water is appropriate as it is a gentle, non-irritating way to keep the area clean. It is important to keep the area dry and clean to prevent infection. Alcohol or antiseptic solutions were previously recommended but are now used less frequently as they can sometimes delay cord separation.

A. Place the newborn in a radiant warmer: While a radiant warmer is useful for addressing hypothermia, the symptoms described, diaphoresis, jitteriness, and lethargy, are more indicative of hypoglycemia, not cold stress. The first step is to check the blood glucose.

B. Monitor the newborn's blood pressure: Although blood pressure may be monitored in cases of neonatal distress, the symptoms described are more likely associated with hypoglycemia, so the priority action should be to check glucose levels.

C. Obtain blood glucose by heel stick: The symptoms of diaphoresis, jitteriness, and lethargy are common signs of hypoglycemia in newborns. A heel stick to obtain blood glucose is the most appropriate action to confirm this and initiate treatment if needed.

D. Initiate phototherapy: Phototherapy is used to treat jaundice (hyperbilirubinemia), but the signs observed do not point to jaundice, making phototherapy an inappropriate first action in this scenario.