A nurse is reinforcing teaching about appropriate exercises during pregnancy with a client who is at 24 weeks of gestation. Which of the following statements indicates a need for additional teaching?

Choice A reason:

Holding the newborn vertically, allowing one foot to touch the crib surface, will elicit the stepping reflex, not the Moro reflex. The stepping reflex is when the newborn makes stepping movements when held upright with one foot touching a flat surface.

Choice B reason:

Turning the newborn's head quickly to one side will elicit the tonic neck reflex, not the Moro reflex. The tonic neck reflex is when the newborn assumes a "fencing”. position, with the arm and leg extended on the side to which the head is turned and the opposite arm and leg flexed.

Choice C reason:

Performing a sharp hand clap near the infant will elicit the Moro reflex, also known as the startle reflex. The Moro reflex is when the newborn responds to a sudden loss of support or a loud noise by extending and abducting the arms, spreading the fingers, and then bringing the arms together and crying.

Choice D reason:

Placing a finger at the base of the newborn's toes will elicit the Babinski reflex, not the Moro reflex. The Babinski reflex is when the newborn fans out the toes and dorsiflexes the big toe when the sole of the foot is stroked.

Choice A reason:

Maternal/newborn blood group incompatibility is the most common cause of pathologic jaundice, which appears within the first 24 hours of life. This occurs when the mother's antibodies attack the newborn's red blood cells, causing hemolysis and increased bilirubin production. The excess bilirubin causes the yellowish discoloration of the skin and mucous membranes.

Choice B reason:

The absence of vitamin K is not related to jaundice but to hemorrhagic disease of the newborn. Vitamin K is essential for blood clotting and is given to newborns as an injection shortly after birth. Newborns are at risk of vitamin K deficiency because they have low levels of vitamin K in their bodies and breast milk, and their intestinal bacteria are not yet able to synthesize vitamin K.

Choice C reason:

Maternal cocaine abuse can cause many complications for the newborn, such as prematurity, low birth weight, neonatal abstinence syndrome, neurobehavioral problems, and congenital anomalies. However, it is not a direct cause of jaundice in the newborn.

Choice D reason:

Physiologic jaundice is a normal and benign condition that affects about 60% of term newborns. It occurs due to the immature liver's inability to metabolize bilirubin effectively. It usually appears after the first 24 hours of life and peaks around the third or fourth day. It does not require treatment unless the bilirubin level is very high or rising rapidly.