A nurse is caring for a newborn with macrosomia who was born vaginally with shoulder dystocia.

Which of the following assessments should the nurse perform to check for a possible brachial plexus injury?

Cover the newborn’s eyes with eye shields or patches.This is because phototherapy exposes the newborn to high-intensity light that can damage the retina and cause eye irritation.Eye shields or patches should be removed every 4 hours to check for eye infection, injury, or displacement.

Choice B is wrong because sunscreen lotion can block the effect of phototherapy and increase the risk of skin irritation and infection.The newborn’s skin should be exposed as much as possible to the light source.

Choice C is wrong because feeding the newborn every 4 hours is not enough to prevent dehydration.Phototherapy can increase insensible water loss and fluid requirements.The newborn should be fed every 2 to 3 hours or on demand, and the urine output and weight should be monitored closely.

Choice D is wrong because turning off the phototherapy lights during blood draws can reduce the efficacy of the treatment and prolong the duration of exposure.The lights should be turned off only when absolutely necessary, such as during physical examination or parental bonding.

Feed the newborn formula or breastmilk as prescribed.This is because newborns with macrosomia (large birth weight) are at risk of hypoglycemia (low blood sugar) due to increased insulin production in response to high glucose levels in the womb.Formula or breastmilk provide adequate glucose and nutrients to prevent or treat hypoglycemia.

Choice B is wrong because glucose water does not provide enough calories or protein for growth and development.

Choice C is wrong because honey or corn syrup can cause infant botulism, a serious infection that affects the nervous system.

Choice D is wrong because rice cereal or oatmeal are not appropriate for newborns, as they can cause choking, allergies, or overfeeding.

Normal ranges for blood glucose levels in newborns are 40 to 150 mg/dL (2.2 to 8.3 mmol/L).Newborns with a suspected or confirmed genetic hypoglycemia disorder have a lower threshold of 70 mg/dL (3.9 mmol/L).