A nurse is assisting in planning care for a newborn who is experiencing neonatal abstinence syndrome. Which of the following actions should the nurse recommend?

(a) Offer an ice pack to the client during the first 24 hr.
Offering an ice pack is an appropriate intervention for managing perineal pain and swelling in the immediate postpartum period. Ice helps to reduce inflammation and numb the area, providing pain relief. This is a standard recommendation for managing perineal pain after vaginal delivery.

(b) Apply a corticosteroid cream to the perineal area twice daily.
Applying a corticosteroid cream is not typically recommended for perineal pain immediately after delivery. These creams are generally used for inflammatory skin conditions and not for the acute management of perineal pain and swelling after childbirth.

(c) Increase the client's fluid intake for 48 hr.
While maintaining adequate hydration is important for overall recovery, increasing fluid intake specifically does not address the client's perineal pain. This intervention would not provide immediate pain relief for the perineal area.

(d) Catheterize the client's bladder.
Catheterizing the bladder is not a standard intervention for perineal pain. It is typically done if the client has urinary retention or difficulty voiding, not for managing pain. This action would not directly alleviate the perineal pain the client is experiencing.

(a) Avoid swaddling the newborn:
Swaddling is actually beneficial for newborns experiencing neonatal abstinence syndrome. It helps provide comfort and security, reducing irritability and promoting better sleep.

(b) Minimize holding the newborn:
Minimizing holding is not recommended. Holding and gentle handling are important as they provide comfort and can help soothe the newborn. Skin-to-skin contact and gentle rocking are beneficial practices for these infants.

(c) Decrease environmental noise:
Decreasing environmental noise is a key intervention for newborns with neonatal abstinence syndrome. These newborns are often hypersensitive to stimuli, and reducing noise helps create a calming environment that can reduce stress and overstimulation.

(d) Avoid using a pacifier:
Using a pacifier can be helpful for soothing a newborn experiencing neonatal abstinence syndrome. Sucking on a pacifier can provide comfort and help with self-regulation, reducing irritability and distress.