A nurse is caring for a client who has a fractured arm in a cast. Which of the following findings about the affected arm should the nurse report to the provider?

A. "Your baby is at a higher risk because they were born with congenital dermal melanocytosis.": Congenital dermal melanocytosis, also known as Mongolian spots, are harmless pigmented birthmarks and are unrelated to bilirubin levels or jaundice risk in newborns.

B. "This is because your baby is breastfed. You should start supplementing with formula.": Breastfeeding itself is not a reason to stop or supplement with formula unless medically necessary. Breastfeeding jaundice can occur, but proper feeding techniques and frequency usually manage it without needing supplementation.

C. "Your baby is at a higher risk because they have had four bowel movements in the first day of life.": Frequent bowel movements actually help lower bilirubin levels by aiding in the excretion of bilirubin through stool, so this would not increase jaundice risk.

D. "This is because your baby's liver is not yet efficient at breaking down red blood cells.": Newborns often experience physiological jaundice because their immature livers cannot efficiently process the breakdown products of red blood cells, leading to elevated bilirubin levels in the blood.

• Hoarseness: Mild hoarseness is a common temporary effect after thyroid surgery due to irritation or swelling near the recurrent laryngeal nerve. While it needs monitoring, slight hoarseness alone is not necessarily a sign of a serious complication if it is not worsening or associated with airway compromise.
• Drainage: A moderate amount of serosanguineous drainage from the incision site is expected after surgery. Although the drainage should continue to be monitored for increase or color change, the amount described here is not immediately concerning for a postoperative complication.
• Sensation: The client reports tingling in the fingers, which suggests hypocalcemia due to accidental removal or damage to the parathyroid glands during surgery. Hypocalcemia is a serious complication of thyroidectomy that can progress to muscle cramps, tetany, and seizures if untreated.
• Vital signs: The client’s rising temperature, tachycardia, hypertension, and increased respiratory rate are concerning for a developing thyroid storm, a rare but life-threatening complication after thyroid surgery. These vital signs warrant immediate intervention to prevent rapid deterioration.
• Pain assessment: A pain score of 3 out of 10 is mild and expected following surgery. This level of discomfort is manageable and not indicative of a major complication, provided it does not rapidly escalate or localize severely around the surgical site.