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) Shivering:

Shivering is a physiological response to cold in which the body generates heat through involuntary muscle contractions. Placing a newborn under a radiant heat warmer helps prevent shivering by maintaining the infant's body temperature within a normal range, reducing the need for compensatory mechanisms such as shivering.

B) Basal metabolic rate reduction:

Basal metabolic rate reduction is not the primary purpose of placing a newborn under a radiant heat warmer. While radiant heat helps maintain body temperature, it does not directly affect the basal metabolic rate, which is the body's energy expenditure at rest.

C) Cold stress:

Placing a newborn under a radiant heat warmer helps prevent cold stress by providing a controlled environment that maintains the infant's body temperature within a normal range. Cold stress occurs when a newborn's body temperature falls below normal, leading to increased oxygen and glucose consumption, metabolic acidosis, and potential complications such as respiratory distress and hypoglycemia.

D) Brown fat production:

Brown fat production is a physiological response to cold exposure in newborns. Brown fat is a specialized type of fat tissue that generates heat when metabolized, helping newborns maintain body temperature during cold exposure. While brown fat production is important for thermoregulation in newborns, placing the infant under a radiant heat warmer primarily aims to prevent cold stress by providing external warmth, rather than stimulating brown fat production.

A) Report of absent breast pain:

Absent breast pain is not a direct indicator of the effectiveness of methylergonovine, which is typically administered to promote uterine contraction and prevent postpartum hemorrhage. Breast pain is more commonly associated with lactation and breastfeeding.

B) Increase in blood pressure:

An increase in blood pressure is not an expected outcome of methylergonovine administration. In fact, methylergonovine can cause transient hypertension as a side effect due to its vasoconstrictive properties.

C) Increase in lochia:

An increase in lochia is not a direct indicator of the effectiveness of methylergonovine. While methylergonovine can promote uterine contractions, leading to expulsion of uterine contents and subsequent decrease in lochia, an increase in lochia might indicate ongoing uterine bleeding or incomplete uterine contraction.

D) Fundus firm to palpation:

The fundus being firm to palpation is the expected outcome of methylergonovine administration. Methylergonovine stimulates uterine contractions, leading to the firming of the uterine fundus. This indicates that the medication is effective in promoting uterine involution and reducing the risk of postpartum hemorrhage.