A nurse is providing teaching to a client who has a prescription for methylprednisolone. Which of the following findings should the nurse include as an adverse effect of this medication?

Choice A reason: Maintaining therapy with the fiber optic pad while allowing parental holding during feedings is correct because it ensures continuous treatment while promoting bonding and feeding. Fiberoptic phototherapy pads are safe to use during holding, and they do not interfere with feeding. This approach balances effective bilirubin reduction with essential parent-infant interaction, which supports emotional well-being and breastfeeding success.

Choice B reason: Discontinuing overhead lights based on stool frequency is incorrect. Increased stooling is a common effect of phototherapy due to bilirubin excretion, but it is not a criterion for discontinuation. Therapy is guided by bilirubin levels and clinical assessment, not stool count. Stopping therapy prematurely could result in rebound hyperbilirubinemia.

Choice C reason: Swaddling the newborn before placing them on the fiber optic pad is inappropriate because swaddling blocks light exposure to the skin, reducing the effectiveness of phototherapy. Direct skin exposure is necessary for maximum bilirubin breakdown.

Choice D reason: Determining the positioning of overhead lights by assessing axillary temperature is incorrect. Temperature monitoring is important to prevent overheating, but light positioning is determined by distance and angle to maximize skin exposure, not by temperature readings.

Choice A reason: Reaching an appropriate body weight is a long-term goal, not a short-term one. Clients with anorexia nervosa require gradual weight restoration to avoid complications such as refeeding syndrome. Setting this as a short-term goal is unrealistic and potentially unsafe.

Choice B reason: Gaining 2 to 3 lb weekly is the correct short-term goal because it is measurable, realistic, and safe. This gradual increase helps stabilize the client’s nutritional status while minimizing medical risks. It also provides a tangible benchmark for progress during inpatient treatment.

Choice C reason: Verbalizing a realistic body image is important but represents a long-term psychosocial goal. Distorted body image is a core feature of anorexia nervosa and requires extended therapy and counseling. It cannot be expected as a short-term outcome during initial hospitalization.

Choice D reason: Developing a personalized meal plan is a collaborative long-term strategy involving dietitians and therapists. While important, it is not the immediate short-term focus. The priority is safe, gradual weight gain.