A nurse is caring for a client who is receiving parenteral nutrition (PN) through a central venous catheter (CVC).

The current PN bag is empty, and a new PN bag is not available at this time.

Which of the following solutions should the nurse infuse until a new PN bag is available?

This statement indicates that the parent understands the signs of acute bilirubin encephalopathy, a serious complication of hyperbilirubinemia that can cause brain damage.

The parent should seek immediate medical attention if these symptoms occur.

Choice B is wrong because “I will keep my baby fully clothed and wrapped in blankets.” This statement indicates that the parent does not understand the role of phototherapy in treating hyperbilirubinemia.Phototherapy is a treatment wherein a baby is placed under a special blue spectrum light to reduce the bilirubin levels.The baby should be exposed to as much light as possible, with only the eyes and genitals covered.

Choice C is wrong because “I will limit breastfeeding to no more than 10 minutes per session.” This statement indicates that the parent does not understand the importance of adequate hydration and nutrition in preventing and treating hyperbilirubinemia.Breastfeeding should not be interrupted or limited, as it provides fluids and calories that help the baby excrete bilirubin through urine and stool.The American Academy of Pediatrics recommends breastfeeding at least 8 to 12 times per day for newborns.

Choice D is wrong because “I will avoid exposing my baby to sunlight or artificial light.” This statement indicates that the parent does not understand the difference between natural and artificial light sources for phototherapy.Sunlight or artificial light from lamps or windows are not effective or safe for treating hyperbilirubinemia, as they do not emit the right wavelength or intensity of light, and they can cause overheating, dehydration, sunburn, or eye damage.

The baby should receive phot

Institute contact precautions.This is because the infant may havenecrotizing enterocolitis (NEC), which is the most common cause of bloody stool in preterm infants.

NEC is a serious condition that involves inflammation and necrosis of the intestinal wall and can lead to perforation, sepsis, and death.NEC is also a potential source of infection for other infants in the NICU, so contact precautions are necessary to prevent cross-contamination.

Choice A is wrong because obtaining a rectal temperature is not indicated for an infant with bloody stool.Rectal temperature can cause irritation and bleeding of the rectal mucosa and can also increase the risk of perforation if there is intestinal necrosis.

Choice C is wrong because decreasing the amount of the feeding is not enough to manage an infant with bloody stool.

The infant may need to have the feeding stopped completely and receive parenteral nutrition until the bowel heals.Decreasing the feeding may also compromise the infant’s growth and development.

Choice D is wrong because assessing for abdominal distention is not a nursing action but a nursing assessment.

Abdominal distention is a common sign of feeding intolerance and NEC, but it is not specific or sensitive enough to diagnose the condition.Other signs and symptoms of NEC include bile-stained or bloody gastric residuals, emesis, diarrhea, temperature instability, apnea, bradycardia, hypotension, and lethargy.