A nurse is caring for a mother who delivered vaginally 2 hr ago. 38 week gestation.Vaginal delivery of a 9-pound 8-ounce baby girl.
Select the 4 findings the nurse should report to the provider.

Choice A rationale: Oxytocin is the hormone responsible for the let-down reflex during breastfeeding. It is released from the posterior pituitary gland in response to the baby’s suckling. This hormone causes the milk ducts to contract and eject milk from the alveoli into the ducts, making it available for the baby.

Choice B rationale: Progesterone plays a role in preparing the breast tissue for lactation during pregnancy, but it does not directly trigger the let-down reflex.

Choice C rationale: Hindmilk is the milk produced later in a feeding session, which is richer in fat and calories. It is not a hormone and does not cause the let-down reflex.

Choice D rationale: Foremilk is the initial milk released during breastfeeding, which is higher in water content. It is also not a hormone and does not cause the let-down reflex.

Choice A rationale: Initiating phototherapy is essential for treating neonatal jaundice. Phototherapy helps to break down bilirubin in the skin, reducing serum bilirubin levels and preventing complications such as kernicterus. It is a common and effective treatment for elevated bilirubin levels in newborns.

Choice B rationale: Administering intravenous dextrose addresses the newborn's low blood glucose level. Hypoglycemia in newborns can lead to severe neurological complications if not treated promptly. Dextrose administration helps stabilize blood glucose levels, improving the newborn's overall condition.

Choice C rationale: Performing a lumbar puncture is not indicated in this scenario. The newborn's symptoms and diagnostic results do not suggest a need for this procedure. Lumbar punctures are typically performed to diagnose conditions such as meningitis, which is not evident here.

Choice D rationale: Encouraging frequent breastfeeding or formula feeding helps in reducing bilirubin levels and maintaining blood glucose levels. Adequate feeding promotes regular bowel movements, aiding in the excretion of bilirubin, and ensures the newborn receives necessary nutrients to stabilize blood glucose levels.

Choice E rationale: Administering naloxone is used for opioid withdrawal, which is not relevant in this case. The newborn's symptoms do not indicate opioid exposure, so this intervention is unnecessary.