A NICU nurse is providing discharge teaching to parents whose infant was born at 36 weeks 4 days.

The newborn required phototherapy for hyperbilirubinemia.

Which explanation of the indication for treatment is correct?

Choice A rationale

A stethoscope is used for auscultating heart, lung, and bowel sounds during a comprehensive physical assessment, and a blood pressure cuff (sized appropriately) is used to measure blood pressure, but neither is the primary equipment for the congenital heart screening (Critical Congenital Heart Disease or CCHD screening), which relies on oxygen saturation measurements.

Choice B rationale

A thermometer is essential for monitoring the newborn's temperature, with a normal range of 36.5°C - 37.5°C (97.7°F - 99.5°F), and a warming blanket helps maintain thermal neutrality, preventing cold stress, but these are general stabilization items, not the specific equipment for the CCHD screening.

Choice C rationale

A syringe and needle are used for invasive procedures like blood sampling for labs such as the newborn metabolic screen or blood gas analysis, but the standard CCHD screening is a non-invasive procedure, using a device to measure oxygen saturation.

Choice D rationale

The CCHD screening involves a pulse oximeter to non-invasively measure SpO_2 (oxygen saturation) in the right hand (pre-ductal) and either foot (post-ductal) to identify potential ductal-dependent cardiac defects, while an ECG machine is sometimes used for a more in-depth assessment or to confirm an arrhythmia but is not standard screening equipment; the pulse oximeter is critical for screening. —.

Choice A rationale

The transition of stool from black meconium to yellow, seedy, and loose is a key indicator of adequate breast milk intake and healthy intestinal function. By three to five days of life, an exclusively breastfed infant should have about three or more yellow, seedy stools per day, confirming effective transfer of nutrients and proper digestion of milk.

Choice B rationale

Newborns generally need to feed frequently, often every two to three hours (or eight to twelve times in 24 hours), especially during the initial weeks, because breast milk is easily and quickly digested. Sleeping for six hours without feeding, especially in the first few weeks, may indicate lethargy or inadequate calorie intake, not necessarily effective feeding.

Choice C rationale

While a good latch is essential for effective milk transfer, the duration of active feeding is typically longer than three to five minutes per breast, particularly when establishing a supply. Active, audible swallowing for 10 to 20 minutes per breast is a more reliable sign that the infant is taking in a sufficient volume of milk for proper growth and hydration.

Choice D rationale

A significant loss of birth weight (greater than 7-10 percent) suggests inadequate intake and is a sign of concern, not a positive indicator of feeding adequacy. Adequate intake is instead indicated by weight regain to birth weight by 10 to 14 days and a subsequent gain of about 15 to 30 g per day thereafter.