A nurse is planning care for a newborn who has spina bifida. Which of the following actions should be included in the plan of care?

A. Applying snug diapers is not recommended as it can put pressure on the sacral lesion, potentially causing damage or infection.
B. Obtaining rectal temperatures is contraindicated due to the risk of bowel and nerve damage.
C. Placing the newborn in the prone position is the correct action, as it prevents pressure on the lesion and reduces the risk of trauma or infection.
D. Covering the lesion with a dry dressing is incorrect. The lesion should be covered with a moist, sterile, non-adherent dressing to prevent drying out and minimize infection risk.

A. Supplementing with formula after breastfeeding due to perceived weight loss may indicate a misunderstanding of normal newborn feeding patterns and could potentially interfere with establishing a sufficient milk supply. Breastfeeding on demand and ensuring proper latch and
positioning are essential for successful breastfeeding. This statement suggests a need for further education about newborn feeding and breastfeeding management.
B. Breastfeeding frequency is crucial for establishing and maintaining milk supply. Newborns typically need to breastfeed at least 8 to 12 times per day to ensure they receive enough milk and to stimulate milk production in the mother's breasts. This statement indicates that the client
understands the importance of frequent feeding for successful breastfeeding.

C. While covering sore nipples with breast pads can provide comfort and protect clothing from leakage, using plastic-lined breast pads after every feeding may not be necessary and could
potentially worsen nipple discomfort. Plastic-lined breast pads can trap moisture, which may
contribute to nipple soreness or increase the risk of developing nipple thrush. Education may be needed to clarify appropriate nipple care and management of nipple discomfort during
breastfeeding.

D. Meconium stools, which are dark and sticky, are normal for newborns in the first few days of life. As the baby begins to digest breast milk, their stools transition from meconium to a yellow, seedy consistency. This statement indicates that the client understands what to expect regarding the color and consistency of their baby's stools after transitioning to breastfeeding.
E. This statement demonstrates an understanding of breast engorgement, a common occurrence when milk production increases in the breasts. Breasts may become harder, warmer, and more
tender when milk "comes in" or when lactation is established. Recognizing these signs indicates that the client is aware of normal changes in their body related to breastfeeding.