A nurse is caring for a newborn 4 hr after birth. Which of the following actions should the nurse include in the plan of care to prevent jaundice?

A) Wash the cord daily with mild soap and water:

This instruction is incorrect. Washing the umbilical cord stump daily with soap and water can increase the risk of infection and delay the drying process. It is recommended to keep the cord stump clean and dry without using soap or other cleansing agents.

B) Give a sponge bath until the cord stump falls off:

This instruction is correct. Until the umbilical cord stump falls off, it is advisable to give the newborn sponge baths rather than immersing them in a tub of water. Sponge baths help keep the cord stump dry and reduce the risk of infection until it naturally separates from the baby's body.

C) Cover the cord with the diaper:

This instruction is incorrect. Covering the umbilical cord stump with a diaper can create a moist environment, which may increase the risk of infection. It is recommended to fold down the top edge of the diaper to expose the cord stump to air and aid in drying.

D) Apply petroleum jelly to the cord stump:

This instruction is not recommended. Applying petroleum jelly or any other substance to the umbilical cord stump can interfere with the drying process and increase the risk of infection. It is best to allow the cord stump to air dry naturally without the use of additional products.

A) A white patch on a nipple:

A white patch on the nipple may indicate a condition such as a milk bleb or a fungal infection like thrush, but it is not characteristic of mastitis. Mastitis typically presents with localized redness and pain in the affected breast, along with other systemic symptoms such as fever and flu-like symptoms.

B) Red and painful area in one breast:

This finding is indicative of mastitis. Mastitis is an inflammation of the breast tissue, often caused by bacterial infection, which presents with localized redness, warmth, swelling, and pain in one breast. The affected area may also feel tender or hard to the touch.

C) Cracked and bleeding nipples:

Cracked and bleeding nipples are common in breastfeeding mothers, but they are not specific signs of mastitis. However, they can increase the risk of mastitis if bacteria enter the breast tissue through the cracked skin. Proper breastfeeding techniques and nipple care can help prevent nipple damage and reduce the risk of mastitis.

D) Swelling in both breasts:

Swelling in both breasts may occur in the early postpartum period due to engorgement or increased milk production, but it is not a specific sign of mastitis. Mastitis typically presents with localized symptoms in one breast rather than both breasts simultaneously.