A nurse is evaluating the effectiveness of phototherapy for a post-term infant who has hyperbilirubinemia due to ABO incompatibility with the mother’s blood type O negative and infant’s blood type B positive.

Which of the following findings indicates that phototherapy is effective?

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

Absent Moro reflex on the affected side indicates a possible injury to the brachial plexus, which is the nerve network that controls the movements and sensations of the shoulder, arm, hand and fingers.Shoulder dystocia can cause brachial plexus injuries when the baby’s shoulder gets stuck behind the mother’s pubic bone during delivery.

Choice B is wrong because flaccid paralysis of both lower extremities is not a common complication of shoulder dystocia.

It could be a sign of spinal cord injury or other neurological disorders.

Choice C is wrong because facial asymmetry when crying or smiling is a sign of facial nerve palsy, which can occur due to compression of the facial nerve during delivery.

It is not specific to shoulder dystocia.

Choice D is wrong because inability to suck or swallow is not a typical sign of shoulder dystocia.

It could be caused by other factors such as prematurity, neurological problems, or congenital anomalies.

Normal ranges for Moro reflex are present at birth and disappear by 4 to 6 months of age.

Normal ranges for facial nerve function are symmetrical movements of both sides of the face.

Normal ranges for sucking and swallowing are coordinated and effective feeding within the first hour after birth.